Moffa, Frederick Allen

Moffa, Frederick Allen is an individual health care provider with primary practice located at 355 Salmon Brook St , Granby CT 06035-1804. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Moffa, Frederick Allen can be contacted via phone (860) 653-7440.

Contact Information

Primary practice address
355 Salmon Brook St Granby CT 06035-1804
Phone: (860) 653-7440
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 2388 Connecticut

Profile Details

NPI number 1679509509
LBN Legal business name Moffa, Frederick Allen
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2006
Last updated Mar 17th, 2022 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679509509 NPPES
Connecticut Other 090002388CT 04 BLUE CROSS BLUE SHIELD
Connecticut MEDICAID 004172699 BLUE CROSS BLUE SHIELD

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