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NPI Profile for Dr MARK J BANNON in KENSINGTON, CT.
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Eyewear Supplier |
332H00000X | 87 | All Other Suppliers | |
Optometrist |
152W00000X | 41 | Optometry |
| NPI # | 1558417949 |
|
| Status | Active | |
| Credentials | OD (Doctor of Optometry) | |
| Entity | Individual | |
| Enumeration date | 01/26/2007 | |
| Last updated | 11/03/2008 - About 18 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
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|
| Hospital affiliation(s) | Not Available |
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MARK J BANNON
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MARK J BANNON, OD