Provider Demographics
NPI:1790740371
Name:MARTINO, SHARON (OD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:
Last Name:MARTINO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:MRS
Other - First Name:SHARON
Other - Middle Name:
Other - Last Name:FREITAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3 HILLSCREST RD
Mailing Address - Street 2:
Mailing Address - City:PLAINVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06062-2111
Mailing Address - Country:US
Mailing Address - Phone:315-445-7465
Mailing Address - Fax:315-445-7675
Practice Address - Street 1:2691 BERLIN TPKE
Practice Address - Street 2:
Practice Address - City:NEWINGTON
Practice Address - State:CT
Practice Address - Zip Code:06111-4114
Practice Address - Country:US
Practice Address - Phone:860-594-4585
Practice Address - Fax:860-667-4377
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT0060221152W00000X
GAOPT002286152W00000X
CT2494152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U75689Medicare UPIN
NYC62321Medicare ID - Type Unspecified