Provider Demographics
NPI:1952433443
Name:VISUAL PERCEPTIONS EYECARE
Entity Type:Organization
Organization Name:VISUAL PERCEPTIONS EYECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:FERENTINI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:860-436-4410
Mailing Address - Street 1:38 FENN RD
Mailing Address - Street 2:
Mailing Address - City:NEWINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06111-2212
Mailing Address - Country:US
Mailing Address - Phone:860-436-4410
Mailing Address - Fax:860-436-4401
Practice Address - Street 1:38 FENN RD
Practice Address - Street 2:
Practice Address - City:NEWINGTON
Practice Address - State:CT
Practice Address - Zip Code:06111-2212
Practice Address - Country:US
Practice Address - Phone:860-436-4410
Practice Address - Fax:860-436-4401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-10
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2332152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT4143020Medicaid
CT004266715Medicaid
CT410000870Medicare ID - Type Unspecified
CT4143020Medicaid
CT004266715Medicaid