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
Update your record
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