Denegre, Mark

Denegre, Mark is an individual health care provider with primary practice located at 90 Main St Suite 101, Centerbrook CT 06409-1056. He recently has only one registered license in Eye and Vision Services Providers / Optician, which is considered as his primary health care specialty. Denegre, Mark can be contacted via phone (860) 767-3206.

Contact Information

Primary practice address
90 Main St Suite 101 Centerbrook CT 06409-1056
Phone: (860) 767-3206
Fax: (860) 767-0836
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optician 156FX1800X 780 Connecticut

Profile Details

NPI number 1659446342
LBN Legal business name Denegre, Mark
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 21st, 2006
Last updated Jan 23rd, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659446342 NPPES
Connecticut Other 200001396CT01 ANTHEM
Connecticut Other 1909 ANTHEM

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