Provider Demographics
NPI:1861475394
Name:COMPARONI, LORI L (OD)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:L
Last Name:COMPARONI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 COOLIDGE RD
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-1378
Mailing Address - Country:US
Mailing Address - Phone:517-337-0316
Mailing Address - Fax:517-337-1779
Practice Address - Street 1:5100 MARSH RD STE H
Practice Address - Street 2:
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-1195
Practice Address - Country:US
Practice Address - Phone:517-349-0150
Practice Address - Fax:517-349-0157
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901003873152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI410041846OtherRAILROAD MEDICARE
MI200000001809OtherPHPMM
MI4901003873OtherSTATE LICENSE
MILC003873OtherSTATE LICENSE NUMBER
MI3423074Medicaid
MIW44944Medicare UPIN