NPIMap

Organization Active NPI

Crystal Vision West Hartford LLC.

  • Optometrist
  • West Hartford, CT
National Provider Identifier
1174926653
Registry record updated Sep 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
002229 Issued in CT
Legal business name
CRYSTAL VISION WEST HARTFORD LLC.
Practice address
64 Raymond Rd
Suite170
West Hartford, CT 06107-2213
Phone
(860) 442-0380
NPI assigned
Sep 29, 2014
Last updated
Sep 29, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Brian Mann, O.DNPI 1942301858
Title
Owner
Phone
(860) 442-0380

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 002229 CT Primary

Addresses

Primary practice location

64 Raymond Rd
Suite170
West Hartford, CT 06107-2213

Mailing address

909 Hartford Tpke
Unit D2
Waterford, CT 06385-4267
Phone (860) 442-0380

National Provider Directory

National Provider Directory

Locations

909 Hartford Tpke
Ste D2
Waterford, CT 06385
Phone (860) 442-0380

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1411948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411948800000",
    "number": "1174926653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 HARTFORD TPKE",
            "address_2": "UNIT D2",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063854267",
            "telephone_number": "860-442-0380",
            "fax_number": "860-437-1717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 RAYMOND RD",
            "address_2": "SUITE170",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061072213",
            "telephone_number": "860-442-0380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL VISION WEST HARTFORD LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-29",
        "last_updated": "2014-09-29",
        "status": "A",
        "authorized_official_last_name": "MANN",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-442-0380",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CT",
            "license": "002229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.