CONSTITUTION EYE SURGERY CENTER LLC NPI 1710904537

NPI Information

  • NPI: 1710904537
  • Provider Name: CONSTITUTION EYE SURGERY CENTER LLC
  • Classification: Clinic/Center - 261QS0132X
  • Specialization: Ophthalmologic Surgery
  • Entity Type: Organization
  • CLIA Number: 07D0990047
  • Address: 505 WILLARD AVE
    BUILDING 3
    NEWINGTON, CT
    ZIP 06111
  • Phone: (860) 665-0174

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NPI Details

CONSTITUTION EYE SURGERY CENTER LLC is an ophthalmologic surgery clinic center in Newington, CT. CONSTITUTION EYE SURGERY CENTER LLC NPI is 1710904537. The provider is registered as an organization entity type.

The provider's business location address is:

505 WILLARD AVE
BUILDING 3
NEWINGTON, CT
ZIP 06111-650
Phone: (860) 665-0174
Fax: (860) 667-2066

The provider's authorized official is Kris Mineau .
The authorized official title is Administrator and has the following contact phone number (860) 665-0174.

The CLIA number assigned to this NPI record is 07D0990047 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/16/2006 and was last updated on 8/17/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QS0132XClinic/CenterOphthalmologic SurgeryYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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