Provider Demographics
NPI:1295180339
Name:TOMMASINA ENTERPRISES, LLC
Entity Type:Organization
Organization Name:TOMMASINA ENTERPRISES, LLC
Other - Org Name:EYES ON LITCHFIELD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TOMMASINA
Authorized Official - Middle Name:PASQUA
Authorized Official - Last Name:SIDERIS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:860-880-2020
Mailing Address - Street 1:17C COMMONS DR
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06759-3448
Mailing Address - Country:US
Mailing Address - Phone:860-880-2020
Mailing Address - Fax:
Practice Address - Street 1:17C COMMONS DR
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:CT
Practice Address - Zip Code:06759-3448
Practice Address - Country:US
Practice Address - Phone:860-880-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-26
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2930152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty