# NORTHEAST VISION CENTER, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316933583
- **Authorized official:** DR. MARIKA PARENTEAU OD (OWNER/DOCTOR)
- **Authorized official phone:** (802) 334-1515

## Contact information

- **Practice address:** 5452 US ROUTE 5, STE H, NEWPORT, VT 05855-9870
- **Practice address phone:** (802) 334-1515
- **Practice address fax:** (802) 334-2935
- **Mailing address:** 5452 US ROUTE 5, STE H, NEWPORT, VT 05855-9870
- **Mailing address phone:** (802) 334-1515
- **Mailing address fax:** (802) 334-2935

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 0300000278 | VT | Yes |

## Other

- **Enumeration date:** 09/23/2005
- **Last updated:** 09/21/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 68799 | BC GROUP NUMBER | VT |
| 01 | — | DA8993 | RR MCR GROUP | VT |