Provider Demographics
NPI:1467625962
Name:TOTALVISION ASSOCIATES OF NORTH HAVEN PC
Entity Type:Organization
Organization Name:TOTALVISION ASSOCIATES OF NORTH HAVEN PC
Other - Org Name:TOTALVISION EYECARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEFLAND
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:203-985-9000
Mailing Address - Street 1:81A WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06473-1704
Mailing Address - Country:US
Mailing Address - Phone:203-985-9000
Mailing Address - Fax:203-985-9210
Practice Address - Street 1:81A WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:NORTH HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06473-1704
Practice Address - Country:US
Practice Address - Phone:203-985-9000
Practice Address - Fax:203-985-9210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-07
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT924152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1199810001Medicare NSC