Ditolla, Kimberly A
Ditolla, Kimberly A is an individual health care provider with primary practice located at 499 Farmington Ave Suite 100, Farmington CT 06032-1943. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Ditolla, Kimberly A can be contacted via phone (860) 678-0202.Contact Information
Primary practice address
499 Farmington Ave Suite 100
Farmington CT 06032-1943
Phone: (860) 678-0202
Fax: (860) 678-0224
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2481 | Connecticut |
Profile Details
| NPI number | 1194909572 |
|---|---|
| LBN Legal business name | Ditolla, Kimberly A |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 20th, 2007 |
| Last updated | Aug 3rd, 2020 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194909572 | NPPES |
| Connecticut | MEDICAID | 004207347 |
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