Provider Demographics
NPI:1831377720
Name:GERARD MICHAEL NOLAN MD PC
Entity type:Organization
Organization Name:GERARD MICHAEL NOLAN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPHTHALMOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:GERARD
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:NOLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-674-9627
Mailing Address - Street 1:PO BOX 827
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06034-0827
Mailing Address - Country:US
Mailing Address - Phone:860-674-9627
Mailing Address - Fax:860-676-8622
Practice Address - Street 1:1 FOREST PARK DR
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-1487
Practice Address - Country:US
Practice Address - Phone:860-674-9627
Practice Address - Fax:860-676-8622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-04
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT4271660001Medicare NSC