Evans, Susan
Evans, Susan is an individual health care provider with primary practice located at 93 Evergreen Way , South Windsor CT 06074-6975. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Evans, Susan can be contacted via phone (860) 826-4460.Contact Information
Primary practice address
93 Evergreen Way
South Windsor CT 06074-6975
Phone: (860) 826-4460
Fax: (860) 826-4436
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 002478 | Connecticut |
Profile Details
| NPI number | 1629106729 |
|---|---|
| LBN Legal business name | Evans, Susan |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 1st, 2007 |
| Last updated | Nov 30th, 2022 - about 2 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 | 1629106729 | NPPES |
| Connecticut | MEDICAID | 004188847 | |
| Connecticut | Other | 1255448155 | |
| Connecticut | Other | CT2478 | |
| Connecticut | Other | 090002478CT04 | |
| Connecticut | Other | 102478 | |
| Connecticut | Other | 1255448155 | |
| Connecticut | Other | 2V9149 | |
| Connecticut | Other | 932470 |
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