Shannon M Mulligan, OD
Optometrist in Waterbury, Connecticut
1528018157- Practice location
- 604 Lakewood RD, Waterbury, CT 06704-2419
- Phone
- 203-575-0900
- Fax
- 203-573-9894
- Last updated
- July 13, 2026
Shannon M Mulligan is an Optometrist based in Waterbury, CT. Shannon M Mulligan practices in Waterbury, CT and has the professional credentials of OD. The NPI Number for Shannon M Mulligan is 1528018157 and holds a License No. 002345 (CT). The current practice location address for Shannon M Mulligan is 604 Lakewood RD, Waterbury, CT 06704-2419 and can be reached out via phone at 203-575-0900 and via fax at 203-573-9894.
Provider Profile Details
- NPI Number
- 1528018157
- Provider Name
- Shannon M Mulligan
- Credential
- OD
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 604 Lakewood RD, Waterbury, CT 06704-2419
- Phone Number
- 203-575-0900
- Fax Number
- 203-573-9894
- Primary Taxonomy
- Optometrist · 152W00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- May 12, 2006
- Last Update Date
- July 13, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 604 Lakewood RD
Waterbury, CT 06704-2419 - City
- Waterbury
- State
- Connecticut
- Zip
- 06704-2419
- Phone Number
- 203-575-0900
- Fax Number
- 203-573-9894
Provider Business Mailing Address Details
- Address
- 87 Grandview Ave
Waterbury, CT 06708-2514 - City
- Waterbury
- State
- CT
- Zip
- 06708-2514
- Phone Number
- 203-574-2020
- Fax Number
- 203-596-2230
License Information
- License Number
- 002345
- License State
- CT
- Taxonomy
- Optometrist · 152W00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Shannon M Mulligan, OD?
The NPI number of Shannon M Mulligan, OD is 1528018157. It was assigned on May 12, 2006 and is currently active in the NPPES registry.
What is the specialty of Shannon M Mulligan, OD?
Shannon M Mulligan, OD is registered under the primary taxonomy Optometrist (code 152W00000X), licensed in CT under license number 002345.
Where does Shannon M Mulligan, OD practice?
The practice location is 604 Lakewood RD, Waterbury, CT 06704-2419. The office can be reached at 203-575-0900 (phone) or 203-573-9894 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1528018157 directly on the NPPES registry website.