Todd, Michelene
Todd, Michelene is an individual health care provider with primary practice located at 775 Main St S , Southbury CT 06488-2271. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Todd, Michelene can be contacted via phone (203) 262-6752.Contact Information
Primary practice address
775 Main St S
Southbury CT 06488-2271
Phone: (203) 262-6752
Fax: (203) 262-6701
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 002362 | Connecticut |
Profile Details
| NPI number | 1962400416 |
|---|---|
| LBN Legal business name | Todd, Michelene |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 8th, 2005 |
| Last updated | Mar 26th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962400416 | NPPES |
| Connecticut | MEDICAID | 004219243 |
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