Provider Demographics
NPI:1659383644
Name:FOREST PARK EYE CARE PC
Entity Type:Organization
Organization Name:FOREST PARK EYE CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRITT
Authorized Official - Middle Name:E
Authorized Official - Last Name:ADORNATO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:413-733-5155
Mailing Address - Street 1:453 SUMNER AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01108-2320
Mailing Address - Country:US
Mailing Address - Phone:413-733-5155
Mailing Address - Fax:413-733-5119
Practice Address - Street 1:453 SUMNER AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01108-2320
Practice Address - Country:US
Practice Address - Phone:413-733-5155
Practice Address - Fax:413-733-5119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA694526OtherTUFTS HEALTH PLANS
MA45812OtherNETWORK HEALTH
MA9731211Medicaid
MAW20352OtherBLUE CROSS BLUE SHIELD
MA694526OtherTUFTS HEALTH PLANS