Villacis, Fabian Cesar

Villacis, Fabian Cesar is an individual health care provider with primary practice located at 1320 W Main St Ste 3 , Waterbury CT 06708-3129. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Villacis, Fabian Cesar can be contacted via phone (203) 755-4941.

Contact Information

Primary practice address
1320 W Main St Ste 3 Waterbury CT 06708-3129
Phone: (203) 755-4941
Fax: (203) 573-8372
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 002832 Connecticut

Profile Details

NPI number 1386939510
LBN Legal business name Villacis, Fabian Cesar
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2011
Last updated Sep 30th, 2019 - about 5 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 1386939510 NPPES
Connecticut MEDICAID 004195063 GR#
Connecticut MEDICAID 8043102

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