Provider Demographics
NPI:1376836379
Name:DR HENRY G. COVETTA, CO
Entity Type:Organization
Organization Name:DR HENRY G. COVETTA, CO
Other - Org Name:NEW VISION EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:G
Authorized Official - Last Name:COVETTA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:440-624-4222
Mailing Address - Street 1:1484 STATE ROUTE 46 NORTH
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:OH
Mailing Address - Zip Code:44047
Mailing Address - Country:US
Mailing Address - Phone:440-624-4222
Mailing Address - Fax:440-624-4232
Practice Address - Street 1:1484 STATE ROUTE 46 N
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:OH
Practice Address - Zip Code:44047-8145
Practice Address - Country:US
Practice Address - Phone:440-624-4222
Practice Address - Fax:440-624-4232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-24
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty