Provider Demographics
NPI:1184122608
Name:TOTALVISION EYE HEALTH CENTER LLC
Entity type:Organization
Organization Name:TOTALVISION EYE HEALTH CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:STRAND
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:860-848-8777
Mailing Address - Street 1:485 WILLARD AVE
Mailing Address - Street 2:
Mailing Address - City:NEWINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06111-2318
Mailing Address - Country:US
Mailing Address - Phone:860-666-7053
Mailing Address - Fax:860-666-7083
Practice Address - Street 1:396 CROMWELL AVE
Practice Address - Street 2:
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-1828
Practice Address - Country:US
Practice Address - Phone:860-666-7053
Practice Address - Fax:860-666-7083
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOTALVISION EYE HEALTH CENTER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-01-30
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty