Healthcare Provider Details

I. General information

NPI: 1528252343
Provider Name (Legal Business Name): LITSCHER EYE CENTER OD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2007
Last Update Date: 09/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

382 N MAIN ST SUITE 101
EAST LONGMEADOW MA
01028-1828
US

IV. Provider business mailing address

PO BOX 10417
HOLYOKE MA
01041-2017
US

V. Phone/Fax

Practice location:
  • Phone: 413-540-0150
  • Fax:
Mailing address:
  • Phone: 413-540-0150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: LARRY LITSCHER
Title or Position: OWNER
Credential: MD
Phone: 413-540-0150