Provider Demographics
NPI:1619501681
Name:VERNON A PERYEA OPTOMETRIST LLC
Entity Type:Organization
Organization Name:VERNON A PERYEA OPTOMETRIST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:VERNON
Authorized Official - Middle Name:ALEN
Authorized Official - Last Name:PERYEA
Authorized Official - Suffix:JR
Authorized Official - Credentials:OD
Authorized Official - Phone:845-221-5310
Mailing Address - Street 1:1123 ROUTE 82
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-6206
Mailing Address - Country:US
Mailing Address - Phone:845-221-5310
Mailing Address - Fax:845-226-1464
Practice Address - Street 1:1123 ROUTE 82
Practice Address - Street 2:
Practice Address - City:HOPEWELL JUNCTION
Practice Address - State:NY
Practice Address - Zip Code:12533-6206
Practice Address - Country:US
Practice Address - Phone:845-221-5310
Practice Address - Fax:845-226-1464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-27
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty