Provider Demographics
NPI:1861914681
Name:PALOZEJ, MATTHEW LANZ (OD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:LANZ
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:06029-5835
Mailing Address - Country:US
Mailing Address - Phone:869-875-7336
Mailing Address - Fax:
Practice Address - Street 1:19 PINNEY ST
Practice Address - Street 2:
Practice Address - City:ELLINGTON
Practice Address - State:CT
Practice Address - Zip Code:06029-5835
Practice Address - Country:US
Practice Address - Phone:860-875-7336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-13
Last Update Date:2017-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3045152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist