Basic Information
| Provider Information | |||||||||
| NPI: | 1851315170 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOCHBERG | ||||||||
| FirstName: | LOUIS | ||||||||
| MiddleName: | G | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8614 WESTWOOD CENTER DR FL 9 | ||||||||
| Address2: | |||||||||
| City: | VIENNA | ||||||||
| State: | VA | ||||||||
| PostalCode: | 221822442 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7038478899 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2165 DIXWELL AVE | ||||||||
| Address2: | |||||||||
| City: | HAMDEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 065142116 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2034073937 | ||||||||
| FaxNumber: | 2034073932 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2006 | ||||||||
| LastUpdateDate: | 09/07/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 947 | CT | Y | Eye and Vision Services Providers | Optometrist |
ID Information
| ID | Type | State | Issuer | Description | 090000947CT01 | 01 | CT | ANTHEM BC/BS | OTHER | 601402 | 01 | CT | AETNA | OTHER | 410000329 | 01 | CT | MEDICARE | OTHER | 004050639 | 05 | CT | MEDICAID | 566941 | 01 | CT | CONNECTICARE | OTHER |