Provider Demographics
NPI:1144680158
Name:CONE, ELDA
Entity type:Individual
Prefix:
First Name:ELDA
Middle Name:
Last Name:CONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:LISBON
Mailing Address - State:CT
Mailing Address - Zip Code:06351-3249
Mailing Address - Country:US
Mailing Address - Phone:860-376-8431
Mailing Address - Fax:860-376-8851
Practice Address - Street 1:180 RIVER RD
Practice Address - Street 2:
Practice Address - City:LISBON
Practice Address - State:CT
Practice Address - Zip Code:06351-3249
Practice Address - Country:US
Practice Address - Phone:860-376-8431
Practice Address - Fax:860-376-8851
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-03
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001503156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician