NPI 1538397419

Elizabeth Fague

Practitioner Optician Waterford, CT

Practice location

Address: 155 Waterford Parkway N., Waterford, CT 06385
Phone: (860) 437-3748
Mailing address: 51 Hi Top Hill Rd, Voluntown, CT 06384-1813

Registered specialties

Optician Primary

Eye and Vision Services Providers Taxonomy 156FX1800X Licence 001497 (CT)

Other Technician/Technologist providers in Connecticut →

Registry record

NPI: 1538397419
Entity type: Individual
Sex (as registered): Female
NPI issued: 30 Jun 2009
Record last updated: 30 Jun 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.