Provider Demographics
NPI:1366554081
Name:FEI, EUGENE YIJIAN (OD)
Entity type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:YIJIAN
Last Name:FEI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:826 E CENTER ST
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-5038
Mailing Address - Country:US
Mailing Address - Phone:203-626-5155
Mailing Address - Fax:203-793-7099
Practice Address - Street 1:826 E CENTER ST
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492
Practice Address - Country:US
Practice Address - Phone:203-626-5155
Practice Address - Fax:203-793-7099
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4523152W00000X
CT002676152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAFE-W17612Medicare ID - Type Unspecified
MAV07443Medicare UPIN