Healthcare Provider Details

I. General information

NPI: 1790740371
Provider Name (Legal Business Name): SHARON MARTINO OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. SHARON FREITAS

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 02/11/2022
Certification Date: 02/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2691 BERLIN TPKE
NEWINGTON CT
06111-4114
US

IV. Provider business mailing address

3 HILLSCREST RD
PLAINVILLE CT
06062-2111
US

V. Phone/Fax

Practice location:
  • Phone: 860-594-4585
  • Fax: 860-667-4377
Mailing address:
  • Phone: 315-445-7465
  • Fax: 315-445-7675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberVUT0060221
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT002286
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2494
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: