NPIMap

Organization Active NPI

Wallingford Optical, LLC

  • Eyewear Supplier
  • Wallingford, CT
National Provider Identifier
1609929983
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
1294 Issued in CT
Legal business name
WALLINGFORD OPTICAL, LLC
Practice address
58 Center St
Wallingford, CT 06492-4112
Phone
(203) 265-1541
NPI assigned
Jan 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. James J Comeau, L.O.NPI 1508934621
Title
Owner
Phone
(203) 265-1541

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 1294 CT Primary

Addresses

Primary practice location

58 Center St
Wallingford, CT 06492-4112

Mailing address

58 Center St
Wallingford, CT 06492-4112
Phone (203) 265-1541

Other identifiers 3

IdentifierTypeStateIssuer
100001294CT02OtherCTBC
51051OtherCTDAVIS VISION
CT1294OtherCTEYEMED

National Provider Directory

National Provider Directory

Locations

58 Center St
Wallingford, CT 06492
Phone (203) 265-1541

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609929983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 CENTER ST",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064924112",
            "telephone_number": "203-265-1541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 CENTER ST",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064924112",
            "telephone_number": "203-265-1541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALLINGFORD OPTICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COMEAU",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-265-1541",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "L.O."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "CT",
            "license": "1294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "100001294CT02",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS VISION",
            "identifier": "51051",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "CT1294",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wallingford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.