Provider Demographics
NPI:1700079928
Name:LAFRENIERE EYE CARE PA
Entity Type:Organization
Organization Name:LAFRENIERE EYE CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:LAFRENIERE
Authorized Official - Suffix:JR
Authorized Official - Credentials:OD
Authorized Official - Phone:603-692-3020
Mailing Address - Street 1:390 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:SOMERSWORTH
Mailing Address - State:NH
Mailing Address - Zip Code:03878-1411
Mailing Address - Country:US
Mailing Address - Phone:603-692-3020
Mailing Address - Fax:603-692-2078
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-21
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0556152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHRE147401Medicare PIN
NHU09860Medicare UPIN
NH0314400001Medicare NSC