Provider Demographics
NPI:1366871220
Name:QUIET CORNER EYECARE, LLC
Entity type:Organization
Organization Name:QUIET CORNER EYECARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEMMA
Authorized Official - Middle Name:S
Authorized Official - Last Name:STIRBA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:860-932-5065
Mailing Address - Street 1:450 PROVIDENCE RD
Mailing Address - Street 2:WALMART VISION CENTER
Mailing Address - City:BROOKLYN
Mailing Address - State:CT
Mailing Address - Zip Code:06234
Mailing Address - Country:US
Mailing Address - Phone:860-932-5065
Mailing Address - Fax:
Practice Address - Street 1:450 PROVIDENCE RD
Practice Address - Street 2:WALMART VISION CENTER
Practice Address - City:BROOKLYN
Practice Address - State:CT
Practice Address - Zip Code:06234
Practice Address - Country:US
Practice Address - Phone:860-932-5065
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-01
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2686152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty