Gordon, Carol E
Gordon, Carol E is an individual health care provider with primary practice located at 1156 Boston Post Rd , Old Saybrook CT 06475-4405. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Gordon, Carol E can be contacted via phone (860) 388-2020.Contact Information
Primary practice address
1156 Boston Post Rd
Old Saybrook CT 06475-4405
Phone: (860) 388-2020
Fax: (860) 388-0889
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2039 | Connecticut |
Profile Details
| NPI number | 1134111966 |
|---|---|
| LBN Legal business name | Gordon, Carol E |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 18th, 2005 |
| Last updated | Dec 29th, 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 | 1134111966 | NPPES |
| Connecticut | MEDICAID | 004097772 |
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