Individual
JOHN MARK LERTORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
38 TUNXIS AVE, SUITE 1, BLOOMFIELD, CT 06002-2034
(860) 243-2508
(860) 243-9332
Mailing address
38 TUNXIS AVE, SUITE 1, BLOOMFIELD, CT 06002-2034
(860) 243-2508
(860) 243-9332
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
002069
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004065280
—
CT
Enumeration date
02/07/2006
Last updated
10/25/2022
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