National Provider Identifier Database

EDWARD J MAMELOK, LO – NPI #1588702559
Optician


Contact Information

EDWARD J MAMELOK, LO
15 ARCADIA ROAD
OLD GREENWICH, CT06870
Phone: 203-698-2255
Fax: 203-698-2655
Website:
Specialty Taxonomy Code
* Optician 156FX1800X

* Indicates primary specialty

NPI Profile & details for EDWARD J MAMELOK

NPI Number 1588702559
Credentials LO
Entity Individual
Enumeration date 02/02/2007
Last updated 07/08/2007 - About 19 years ago
Sole proprietor1 Yes
Identifiers
  • CT License #: 001192
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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