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
Fax: (203) 262-6701
Website:

Health care specialties

SpecialtyCodeLicense #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 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962400416 NPPES
Connecticut MEDICAID 004219243

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