Provider Demographics
NPI:1053372607
Name:STROM, JENNIFER KAREN (OD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:KAREN
Last Name:STROM
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 WEST ST
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06759-3501
Mailing Address - Country:US
Mailing Address - Phone:860-567-4565
Mailing Address - Fax:
Practice Address - Street 1:29 WEST ST
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:CT
Practice Address - Zip Code:06759-3501
Practice Address - Country:US
Practice Address - Phone:860-567-4565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV0064631152W00000X
CT003383152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist