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General NPI Number Information
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NPI Number | 1861595027
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Entity Type | Individual
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Provider Name | LEORA A BERNS OD
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Gender | Female
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Dates
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Enumeration Date | 09/06/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 43 WEST MAIN STREET
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City | AVON
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State | CT
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Zip | 06001
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Country | US
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Telephone | 860-676-2376
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Fax | 860-677-0517
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Provider Business Mailing Address
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Address Line | 43 WEST MAIN STREET
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City | AVON
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State | CT
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Zip | 06001
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Country | US
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Telephone | 860-676-2376
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Fax | 860-677-0517
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 002118
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License Number State | CT
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