Provider Demographics
NPI:1245996123
Name:VISTA VISION INC
Entity type:Organization
Organization Name:VISTA VISION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROCHA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:857-615-9071
Mailing Address - Street 1:50 HAMILTON ST
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:MA
Mailing Address - Zip Code:02149-5325
Mailing Address - Country:US
Mailing Address - Phone:857-615-9071
Mailing Address - Fax:
Practice Address - Street 1:1885 REVERE BEACH PKWY STE 3
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:MA
Practice Address - Zip Code:02149-5923
Practice Address - Country:US
Practice Address - Phone:857-615-9071
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-15
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty