Healthcare Provider Details

I. General information

NPI: 1124958145
Provider Name (Legal Business Name): EYECONIC VISION CARE, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

798 MAIN ST STE 2
SOUTH PORTLAND ME
04106-2434
US

IV. Provider business mailing address

9 SMITH LN
LYMAN ME
04002-8103
US

V. Phone/Fax

Practice location:
  • Phone: 207-761-9054
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KIRSTEN TURRISI
Title or Position: OWNER
Credential: OD
Phone: 207-806-9349