Basic Information
| Provider Information | |||||||||
| NPI: | 1063496024 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NEARING | ||||||||
| FirstName: | MARCIA | ||||||||
| MiddleName: | Y. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 54 PARK LANE RD | ||||||||
| Address2: | |||||||||
| City: | NEW MILFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 067762917 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8603540130 | ||||||||
| FaxNumber: | 8603549058 | ||||||||
| Practice Location | |||||||||
| Address1: | 54 PARK LANE RD | ||||||||
| Address2: | |||||||||
| City: | NEW MILFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 067762917 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8603540130 | ||||||||
| FaxNumber: | 8603549058 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/02/2005 | ||||||||
| LastUpdateDate: | 05/08/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 002769 | CT | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.