Provider Demographics
NPI:1144025073
Name:CONNECTICUT CONTACT LENS INSTITUTE LLC
Entity type:Organization
Organization Name:CONNECTICUT CONTACT LENS INSTITUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:YU
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:203-232-3234
Mailing Address - Street 1:116 WELLS VIEW RD
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-5661
Mailing Address - Country:US
Mailing Address - Phone:203-232-3234
Mailing Address - Fax:
Practice Address - Street 1:115 OLD RIDGEFIELD RD STE 101B
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:CT
Practice Address - Zip Code:06897-3019
Practice Address - Country:US
Practice Address - Phone:203-834-0860
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty