Organization
NORTHERN VALLEY EYECARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GRETA M. BOULERICE (OFFICE ADMINISTRATOR)
(802) 524-9561
Entity
Organization
Contact information
Practice address
128 FISHER POND RD, SAINT ALBANS, VT 05478-6058
(802) 524-9561
(802) 524-6060
Mailing address
128 FISHER POND RD, SAINT ALBANS, VT 05478-6058
(802) 524-9561
(802) 524-6060
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
328, 140, 263
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1010944
—
VT
01
—
200000905
MVP HEALTH CARE
VT
01
—
DC6158
RAILROAD MEDICARE
VT
01
—
NORT00007939
BLUE CROSS/BLUE SHIELD
VT
Enumeration date
09/30/2005
Last updated
03/11/2022
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