Provider Demographics
NPI:1346638533
Name:RUTHERFORD VISION CARE, LLC
Entity Type:Organization
Organization Name:RUTHERFORD VISION CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:RUTHERFORD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:203-216-3982
Mailing Address - Street 1:553 POST RD
Mailing Address - Street 2:RUTHERFORD VISION CARE C/O DARIEN EYECARE
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820-3609
Mailing Address - Country:US
Mailing Address - Phone:203-878-2020
Mailing Address - Fax:203-878-1783
Practice Address - Street 1:10 CROWNE POND LN
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:CT
Practice Address - Zip Code:06897-3029
Practice Address - Country:US
Practice Address - Phone:203-974-2294
Practice Address - Fax:203-900-8733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-23
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2908152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty