Mark T Lopez OD PC
Organization Active NPI Optometrist · Gales Ferry, CT
NPI 1376715680 · NPPES record last updated Feb 4, 2011
Key facts
- NPI
- 1376715680
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- CT856 (CT)
- Legal business name
- MARK T LOPEZ OD PC
- Practice address
- 1026 Long Cove Rd
Gales Ferry, CT 06335-1812 - Phone
- (860) 464-6060
- Fax
- (860) 464-7013
- NPI assigned
- Mar 26, 2008
- Organization subpart
- No
Authorized official
- Name
- Dr. Mark Lopez
- Title
- Doctor
- Phone
- (860) 464-6060
National Provider Directory
Locations
1026 Long Cove Rd
Gales Ferry, CT 06335
Phone (860) 464-6060
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | CT856 | CT | Yes |
Addresses
Primary practice location
1026 Long Cove Rd
Gales Ferry, CT 06335-1812
Mailing address
1026 Long Cove Rd
P.O. Box 336
Gales Ferry, CT 06335-1812
Phone (860) 464-6060
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004021507 | Medicaid | CT |
Other providers in Gales Ferry, CT
- Nancy C Linn
- Wendy P Login
- Mark T Lopez
- Jennifer R. Lovin
- Simon Matthew Makuchowski
- Michelle a. Tucker, LLC
- Marion Krista Mikkelson
- Amy T Mooradian
- Patricia Ward Murdoch
- New Moon Therapy LLC
All providers in Gales Ferry, CT · Optometrist in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 4, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.