Provider Demographics
NPI:1962770669
Name:OMNIVISION EYE ASSOCIATES INC
Entity type:Organization
Organization Name:OMNIVISION EYE ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:GARY
Authorized Official - Last Name:HOCHBERG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:203-287-1595
Mailing Address - Street 1:1970 WHITNEY AVE
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06517-1206
Mailing Address - Country:US
Mailing Address - Phone:203-287-1595
Mailing Address - Fax:203-230-9579
Practice Address - Street 1:1970 WHITNEY AVE
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06517-1206
Practice Address - Country:US
Practice Address - Phone:203-287-1595
Practice Address - Fax:203-230-9579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-08
Last Update Date:2016-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT947152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty