Provider Demographics
NPI:1417265372
Name:SPARKS, SHERI M (OD)
Entity Type:Individual
Prefix:DR
First Name:SHERI
Middle Name:M
Last Name:SPARKS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:530 BUSHY HILL RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:SIMSBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06070-2995
Mailing Address - Country:US
Mailing Address - Phone:860-651-3403
Mailing Address - Fax:860-651-5919
Practice Address - Street 1:4 NORTHWESTERN DR STE 400
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-3444
Practice Address - Country:US
Practice Address - Phone:860-243-2020
Practice Address - Fax:860-243-5190
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-14
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3975152WC0802X
CT002649152WC0802X
CT2649152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management