Provider Demographics
NPI:1477604569
Name:PARIZO'S SPECTACLE SHOPPE, P.C.
Entity Type:Organization
Organization Name:PARIZO'S SPECTACLE SHOPPE, P.C.
Other - Org Name:PARIZO'S CHAMPAIN VALLEY EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:PARIZO
Authorized Official - Suffix:
Authorized Official - Credentials:ABOC
Authorized Official - Phone:802-775-2660
Mailing Address - Street 1:69 WOODSTOCK AVE
Mailing Address - Street 2:
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05701-3535
Mailing Address - Country:US
Mailing Address - Phone:802-775-2660
Mailing Address - Fax:802-775-8911
Practice Address - Street 1:69 WOODSTOCK AVE
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-3535
Practice Address - Country:US
Practice Address - Phone:802-775-2660
Practice Address - Fax:802-775-8911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT208156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT4406780001Medicare NSC