MEDICARE: FOREST PARK EYE CARE PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist		MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	694526	OTHER	MA	TUFTS HEALTH PLANS
2	45812	OTHER	MA	NETWORK HEALTH
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	W20352	OTHER	MA	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1659383644
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOREST PARK EYE CARE PC

Provider Business Mailing Address
First Line	:	453 SUMNER AVE
Second Line	:
City	:	SPRINGFIELD
State	:	MA
Zip	:	01108-2320
Country	:	US
Telephone Number	:	413-733-5155
Fax Number	:	413-733-5119

Provider Business Practice Location Address
First Line	:	453 SUMNER AVE
Second Line	:
City	:	SPRINGFIELD
State	:	MA
Zip	:	01108-2320
Country	:	US
Telephone Number	:	413-733-5155
Fax Number	:	413-733-5119

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. BRITT E ADORNATO
Credential	:	O.D.
Telephone Number	:	413-733-5155

Provider Enumeration Date	:	08/12/2006
Last Update Date	:	07/21/2022

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Directions to “FOREST PARK EYE CARE PC ” Practice Location

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