Eye Surgery Associates Optical, LLC

Primary specialty

Ophthalmologic Surgery Clinic/CenterTaxonomy code 261QS0132X

Legal business name

EYE SURGERY ASSOCIATES OPTICAL, LLC

Practice address

495 Hawley LN
Stratford, CT 06614-1514

Phone

(203) 375-5819

NPI assigned

Oct 3, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Brian M Debroff, MD

Title

Owner

Phone

(203) 375-5819

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1538524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538524800000",
    "number": "1184109332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 HAWLEY LN",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066141514",
            "telephone_number": "203-375-5819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 HAWLEY LN",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066141514",
            "telephone_number": "203-375-5819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE SURGERY ASSOCIATES OPTICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-03",
        "last_updated": "2018-10-03",
        "status": "A",
        "authorized_official_last_name": "DEBROFF",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-375-5819",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmologic Surgery Clinic/Center in Stratford, CT
• Providers in Stratford, CT by specialty
• Ophthalmologic Surgery Clinic/Center in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2018; 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.