Provider Demographics
NPI:1275817678
Name:FAMILY EYE CARE LLC
Entity Type:Organization
Organization Name:FAMILY EYE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:ZERVAS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:860-584-5528
Mailing Address - Street 1:780 KING ST
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-4480
Mailing Address - Country:US
Mailing Address - Phone:860-584-5528
Mailing Address - Fax:860-583-4949
Practice Address - Street 1:780 KING ST
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-4480
Practice Address - Country:US
Practice Address - Phone:860-584-5528
Practice Address - Fax:860-583-4949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-04
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002358152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004134615Medicaid
CTU50128Medicare UPIN