Provider Demographics
NPI:1962540195
Name:FRITZ EYECARE INC
Entity type:Organization
Organization Name:FRITZ EYECARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:E.
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:FRITZ
Authorized Official - Suffix:
Authorized Official - Credentials:LO
Authorized Official - Phone:203-488-9900
Mailing Address - Street 1:267 E MAIN ST
Mailing Address - Street 2:#4
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-3126
Mailing Address - Country:US
Mailing Address - Phone:203-488-9900
Mailing Address - Fax:203-488-9900
Practice Address - Street 1:267 E MAIN ST
Practice Address - Street 2:#4
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-3126
Practice Address - Country:US
Practice Address - Phone:203-488-9900
Practice Address - Fax:203-488-9900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001409332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1016690001Medicare ID - Type UnspecifiedPROVIDER NUMBER