Provider Demographics
NPI:1669544300
Name:LAFRENIERE, CHARLES FRANCIS (OD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:FRANCIS
Last Name:LAFRENIERE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 WHITEHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03867-4565
Mailing Address - Country:US
Mailing Address - Phone:603-335-3385
Mailing Address - Fax:
Practice Address - Street 1:390 HIGH ST
Practice Address - Street 2:
Practice Address - City:SOMERSWORTH
Practice Address - State:NH
Practice Address - Zip Code:03878-1411
Practice Address - Country:US
Practice Address - Phone:603-692-3020
Practice Address - Fax:603-692-2078
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0556152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHU09860OtherHARVARD PILGRIM PROVIDER
NH0906421Y0NH01OtherANTHEM INSURANCE PROVIDER
NHU09860OtherHARVARD PILGRIM PROVIDER
NHRE4078Medicare ID - Type Unspecified