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General NPI Number Information
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NPI Number | 1154449213
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Entity Type | Organization
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Legal Business Name | VISION CENTER OF FARMINGTON VALLEY LLC
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 110 HOPMEADOW ST SUITE 100
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City | WEATOGUE
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State | CT
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Zip | 06089-9407
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Country | US
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Telephone | 860-658-1704
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Fax | 860-651-9966
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Provider Business Mailing Address
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Address Line | 110 HOPMEADOW ST SUITE 100
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City | WEATOGUE
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State | CT
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Zip | 06089-9407
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Country | US
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Telephone | 860-658-1704
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Fax | 860-651-9966
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Authorized Official
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Title or Position | LICENSED OPTICIAN OWNER
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Name | MR. JOSEPH SYLVESTRE
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Credential |
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Telephone | 860-658-1704
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | CT1222
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License Number State | CT
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