Provider Demographics
NPI:1154449213
Name:VISION CENTER OF FARMINGTON VALLEY LLC
Entity Type:Organization
Organization Name:VISION CENTER OF FARMINGTON VALLEY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED OPTICIAN OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:SYLVESTRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-658-1704
Mailing Address - Street 1:110 HOPMEADOW ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WEATOGUE
Mailing Address - State:CT
Mailing Address - Zip Code:06089-9407
Mailing Address - Country:US
Mailing Address - Phone:860-658-1704
Mailing Address - Fax:860-651-9966
Practice Address - Street 1:110 HOPMEADOW ST
Practice Address - Street 2:SUITE 100
Practice Address - City:WEATOGUE
Practice Address - State:CT
Practice Address - Zip Code:06089-9407
Practice Address - Country:US
Practice Address - Phone:860-658-1704
Practice Address - Fax:860-651-9966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCT1222156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty