Provider Demographics
NPI:1730788688
Name:NORWALK VISION CENTER LLC
Entity type:Organization
Organization Name:NORWALK VISION CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JASON
Authorized Official - Last Name:FOLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:203-866-3280
Mailing Address - Street 1:148 EAST AVE STE 3C
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-5736
Mailing Address - Country:US
Mailing Address - Phone:203-866-3280
Mailing Address - Fax:203-866-1124
Practice Address - Street 1:148 EAST AVE STE 3C
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-5736
Practice Address - Country:US
Practice Address - Phone:203-866-3280
Practice Address - Fax:203-866-1124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Multi-Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Multi-Specialty
No156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty