Norwich Ophthalmology Optical, Inc.

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

001624 Issued in CT

Legal business name

NORWICH OPHTHALMOLOGY OPTICAL, INC.

Practice address

188 Norwich Ave
Colchester, CT 06415-1256

Phone

(860) 537-4644

Fax

(860) 537-2501

NPI assigned

Jul 7, 2009

Organization subpart

Yes

Parent organization

NORWICH OPHTHALMOLOGY OPTICAL INC.As reported in NPPES

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

Authorized official

Name

Dr. Jeffrey A. Hertz, M.D.NPI 1881623486

Title

President

Phone

(860) 886-0161

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• EyeQ Optical Doing business as

Part of

Norwich Ophthalmology Optical

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Norwich Ophthalmology Optical

  • Eyewear Supplier
  • Norwich, CT
  • NPI 1427081199
  NPPES parent name

Practitioners 4

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

• Jeffrey A Hertz, MD

  • Ophthalmology Physician
  • Norwich, CT
  • NPI 1881623486
  NPD (past) Authorized official
• Peter S McKay, MD

  • Ophthalmology Physician
  • Norwich, CT
  • NPI 1235163361
  NPD (past)
• Anish U Shah, MD

  • Ophthalmology Physician
  • Norwich, CT
  • NPI 1528092657
  NPD (past)
• Ronald Slocumb, MD

  • Ophthalmology Physician
  • Norwich, CT
  • NPI 1699893545
  NPD (past)

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

{
    "created_epoch": "1246924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305676800000",
    "number": "1962631366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 WAWECUS ST",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602160",
            "telephone_number": "860-886-0161",
            "fax_number": "860-889-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 NORWICH AVE",
            "city": "COLCHESTER",
            "state": "CT",
            "postal_code": "064151256",
            "telephone_number": "860-537-4644",
            "fax_number": "860-537-2501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORWICH OPHTHALMOLOGY OPTICAL, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORWICH OPHTHALMOLOGY OPTICAL  INC.",
        "enumeration_date": "2009-07-07",
        "last_updated": "2011-05-18",
        "status": "A",
        "authorized_official_last_name": "HERTZ",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "860-886-0161",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "CT",
            "license": "000433",
            "primary": false
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "CT",
            "license": "001624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008004664",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EyeQ Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anthony Hugh Morgan, DPM
• Rebecca Lynn Mulcahy, PTA
• Tara Murphy
• Amy D Neumann, OTRL, MBA
• Jennifer G Newton, RPH
• Karissa Nott, RN
• Nurturing Connections LLC
• Danielle Opalenik
• Kathleen Paganetti, COTA/L
• John Alexander Pagnani, PSY. D.

• Eyewear Supplier in Colchester, CT
• Providers in Colchester, CT by specialty
• Eyewear Supplier in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2011; 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.