Provider Demographics
NPI:1477513851
Name:PALOZEJ, ROBERT R (OD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:R
Last Name:PALOZEJ
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 1:19 PINNEY ST
Mailing Address - Street 2:
Mailing Address - City:ELLINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06029-3812
Mailing Address - Country:US
Mailing Address - Phone:860-875-7336
Mailing Address - Fax:860-870-4707
Practice Address - Street 1:19 PINNEY ST
Practice Address - Street 2:
Practice Address - City:ELLINGTON
Practice Address - State:CT
Practice Address - Zip Code:06029-3812
Practice Address - Country:US
Practice Address - Phone:860-875-7336
Practice Address - Fax:860-870-4707
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000929152W00000X, 152WC0802X, 152WP0200X, 152WS0006X, 152WV0400X, 152WX0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered152W00000XEye and Vision Services ProvidersOptometrist
Not Answered152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Not Answered152WP0200XEye and Vision Services ProvidersOptometristPediatrics
Not Answered152WS0006XEye and Vision Services ProvidersOptometristSports Vision
Not Answered152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Not Answered152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT061615194 0002OtherCIGNA
CT4258OtherCONNECTICARE
CTP381699OtherOXFORD
CT50RPALOZECT01OtherANTHEM
CTPR50304310001OtherCIGNA
CT722718OtherCONNECTICARE
CT56090000929CT2OtherANTHEM
CT0004236477OtherAETNA
CT2501130OtherAETNA
CTP381699OtherOXFORD