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General NPI Number Information
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NPI Number | 1457769226
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Entity Type | Organization
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Legal Business Name | CHROMA OPTICS PLLC
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Dates
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Enumeration Date | 07/24/2014
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Last Update Date | 03/26/2024
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Provider Practice Location Address
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Address Line | 370 SHELBURNE RD SUITE 1
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City | BURLINGTON
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State | VT
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Zip | 05401-4937
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Country | US
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Telephone | 802-497-1676
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Fax | 802-497-2479
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Provider Business Mailing Address
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Address Line | 370 SHELBURNE RD SUITE 1
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City | BURLINGTON
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State | VT
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Zip | 05401-4937
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Country | US
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Telephone | 802-497-1676
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Fax | 802-497-2479
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Authorized Official
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Title or Position | OWNER
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Name | DORA SUDARSKY
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Credential | O.D.
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Telephone | 802-497-1676
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0300000264
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License Number State | VT
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