Noreen Dedomenico, OPTICIAN

Primary specialty

OpticianTaxonomy code 156FX1800X

License

LO702 Issued in CT

Practice address

904 Whalley Ave
New Haven, CT 06515-1700

Phone

(203) 397-1928

NPI assigned

Apr 12, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Mrs. Noreen Dedomenico Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Westvillage Optician

  • Optician
  • New Haven, CT
  • NPI 1619198181
  NPD (past)

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261094400000",
    "number": "1891919585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 STANLEY RD",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065143238",
            "telephone_number": "203-288-0409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 WHALLEY AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065151700",
            "telephone_number": "203-397-1928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEDOMENICO",
        "first_name": "NOREEN",
        "name_prefix": "Mrs.",
        "credential": "OPTICIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2009-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "CT",
            "license": "LO702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "0521380001",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "100000702CT01",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NOREEN",
            "last_name": "DEDOMENICO",
            "prefix": "MRS.",
            "credential": "OPTICIAN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Dominique Decilla, LCSW
• Hannah Babbitt Deck, APRN
• Christopher Paul Decker, APRN
• Korynne Joy Decloux, MD
• Cheryl Anne Dedios-Kenn, L.C.S.W.
• Jennifer Dedominicis, PA
• Marion Elizabeth Deerhake, MD, PHD
• Nicholas Angelo Defilippo, PHARMD, RPH
• Gabrielle Deford, LCSW
• Janine N Defrank, PA

• Optician in New Haven, CT
• Providers in New Haven, CT by specialty
• Optician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2009; 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.