MEDICARE: LINDSEY M VERNILLO OD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist

General Provider Information

NPI Number	:	1477132868
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINDSEY M VERNILLO OD PC

Provider Business Mailing Address
First Line	:	160 MOUNT PLEASANT RD
Second Line	:
City	:	CHESAPEAKE
State	:	VA
Zip	:	23322-4152
Country	:	US
Telephone Number	:	757-482-4022
Fax Number	:	757-482-9065

Provider Business Practice Location Address
First Line	:	160 MOUNT PLEASANT RD
Second Line	:
City	:	CHESAPEAKE
State	:	VA
Zip	:	23322-4152
Country	:	US
Telephone Number	:	757-482-4022
Fax Number	:	757-482-9065

Authorized Official
Title or Position	:	OWNER
Name	:	LINDSEY M VERNILLO
Credential	:	OD
Telephone Number	:	757-482-4022

Provider Enumeration Date	:	04/05/2021
Last Update Date	:	10/26/2022

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