Provider Demographics
NPI:1316241466
Name:NEW INSIGHT FAMILY EYECARE
Entity type:Organization
Organization Name:NEW INSIGHT FAMILY EYECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:GERMAIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:203-755-4941
Mailing Address - Street 1:1320 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-3119
Mailing Address - Country:US
Mailing Address - Phone:203-755-4941
Mailing Address - Fax:203-573-8372
Practice Address - Street 1:1320 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-3119
Practice Address - Country:US
Practice Address - Phone:203-755-4941
Practice Address - Fax:203-573-8372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-04
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT896152WC0802X, 152WP0200X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Multi-Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT4318020OtherAETNA
CT678924OtherCT CARE
CTORO910OtherHEALTH NET
CT4611928OtherCIGNA
CT090000896CT01OtherANTHEM BLUE CROSS
CTP377996OtherOXFORD
CT4052197Medicaid
CTT23137Medicare UPIN
CT4611928OtherCIGNA