Individual provider · NPI-1

Dr. Mark R Chasse, OD

Optometrist · Cromwell, CT

NPI number1699742429
StatusActive
Last updated in NPPESSep 10, 2007

Details

NPI
1699742429
Entity type
Individual (NPI-1)
Name
Dr. Mark R Chasse
Credential
OD
Sex
Male
Sole proprietor
Yes
Enumeration date
Mar 1, 2006
Last updated
Sep 10, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
152W00000X Optometrist939CTYes
152W00000X Optometrist2893MA

Practice location

160 West St
Cromwell, CT 06416-2441

Phone 860-635-6149 · Fax 860-632-1401

Mailing address

160 West St
Cromwell, CT 06416-2441

Phone 860-635-6149 · Fax 860-632-1401

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