Bohman, Bradley Peter
Bohman, Bradley Peter is an individual health care provider with primary practice located at Vision Center 155 Waterford Pkwy North, Waterford CT 06385. He recently has only one registered license in Eye and Vision Services Providers / Optician, which is considered as his primary health care specialty. Bohman, Bradley Peter can be contacted via phone (860) 437-3748.Contact Information
Primary practice address
Vision Center 155 Waterford Pkwy North
Waterford CT 06385
Phone: (860) 437-3748
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optician | 156FX1800X | 632 | Connecticut |
Profile Details
| NPI number | 1023245776 |
|---|---|
| LBN Legal business name | Bohman, Bradley Peter |
| Credentials | LO |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 19th, 2009 |
| Last updated | Jun 19th, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023245776 | NPPES |
| Connecticut | Other | 581910859 | TAX ID |
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