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Organization

PLAINVILLE OPTICAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JONATHAN LINDBERG (OWNER & LICENSED OPTICIAN)
(860) 793-9378
Entity
Organization

Contact information

Practice address
28 EAST ST, PLAINVILLE, CT 06062-2309
(860) 793-9378
(860) 793-2494
Mailing address
28 EAST ST, PLAINVILLE, CT 06062-2309
(860) 793-9378
(860) 793-2494

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
001471
CT
332H00000X
Eyewear Supplier
Primary
CT1106
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004098556
CT
01
090001012CT01
ANTHEM BCBS
CT
01
2V5403
HEALTHNET
CT
01
720325
CONNECTICARE
CT
Enumeration date
03/16/2007
Last updated
07/23/2015
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