Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156FC0801X | Contact Lens Fitter | ||
Y | 156FX1800X | Optician |
NPI | 1003574773 |
---|---|
Provider Name | Mrs. Heather Hall Mazzaferro |
First Address | Winsted, CT 06098-1439 |
Second Address | Torrington, CT 06790-7201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2021 |
Last Update Date | 30/11/2021 |