Provider Demographics
NPI:1548024664
Name:PALOZEJ, RILEY KATE (OD)
Entity type:Individual
Prefix:DR
First Name:RILEY
Middle Name:KATE
Last Name:PALOZEJ
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 1:72 W STAFFORD RD # II
Mailing Address - Street 2:
Mailing Address - City:STAFFORD SPRINGS
Mailing Address - State:CT
Mailing Address - Zip Code:06076-1000
Mailing Address - Country:US
Mailing Address - Phone:860-684-2191
Mailing Address - Fax:
Practice Address - Street 1:72 W STAFFORD RD # II
Practice Address - Street 2:
Practice Address - City:STAFFORD SPRINGS
Practice Address - State:CT
Practice Address - Zip Code:06076-1000
Practice Address - Country:US
Practice Address - Phone:860-684-2191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3332152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist