Provider Demographics
NPI:1457769226
Name:CHROMA OPTICS PLLC
Entity Type:Organization
Organization Name:CHROMA OPTICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DORA
Authorized Official - Middle Name:
Authorized Official - Last Name:SUDARSKY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:802-497-1676
Mailing Address - Street 1:370 SHELBURNE RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-4937
Mailing Address - Country:US
Mailing Address - Phone:802-497-1676
Mailing Address - Fax:802-497-2479
Practice Address - Street 1:370 SHELBURNE RD
Practice Address - Street 2:SUITE 1
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-4937
Practice Address - Country:US
Practice Address - Phone:802-497-1676
Practice Address - Fax:802-497-2479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-24
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0300000264152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1023667Medicaid