Provider Demographics
NPI:1548531809
Name:KELLI ARMSTRONG, PC
Entity type:Organization
Organization Name:KELLI ARMSTRONG, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:
Authorized Official - Last Name:ARMSTRONG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:203-783-9632
Mailing Address - Street 1:50 CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-3487
Mailing Address - Country:US
Mailing Address - Phone:203-783-9632
Mailing Address - Fax:203-874-7435
Practice Address - Street 1:50 CHERRY ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-3487
Practice Address - Country:US
Practice Address - Phone:203-783-9632
Practice Address - Fax:203-874-7435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-19
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2024152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTD100065622Medicare PIN
CTT22779Medicare UPIN