Provider Demographics
NPI:1174745996
Name:RIDGEFIELD EYECARE,INC.
Entity type:Organization
Organization Name:RIDGEFIELD EYECARE,INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:USHER
Authorized Official - Suffix:
Authorized Official - Credentials:LO
Authorized Official - Phone:203-438-7601
Mailing Address - Street 1:88 DANBURY RD
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-4068
Mailing Address - Country:US
Mailing Address - Phone:203-438-7601
Mailing Address - Fax:203-431-4968
Practice Address - Street 1:88 DANBURY RD
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-4068
Practice Address - Country:US
Practice Address - Phone:203-438-7601
Practice Address - Fax:203-431-4968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001406332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier