Provider Demographics
NPI:1285769703
Name:NEUMANN, LOUIS R (OD)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:R
Last Name:NEUMANN
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:PO BOX 527
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:CT
Mailing Address - Zip Code:06480-0527
Mailing Address - Country:US
Mailing Address - Phone:860-342-3224
Mailing Address - Fax:
Practice Address - Street 1:511 MAIN ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:CT
Practice Address - Zip Code:06480-1527
Practice Address - Country:US
Practice Address - Phone:860-342-3224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT742152W00000X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004023990Medicaid
CTOV2107OtherHEALTHNET
CTP385654OtherOXFORD
CT090000742CT01OtherANTHEM
CT090000742CT02OtherANTHEM
CT0991796OtherAETNA
CT907652OtherBLOCK VISION
CT0329500001Medicare NSC
CTP385654OtherOXFORD
CT090000742CT02OtherANTHEM