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DR. JEANETTE JEZICK OD. LLC NPI 1144556192


NPI Information

NPI: 1144556192
Provider Name: DR. JEANETTE JEZICK OD., LLC

Doing Business As: EYECARE EXPRESSIONS

Classification: Optometrist - 152W00000X
Entity Type: Organization
Address:
1663 ROUTE 12
GALES FERRY, CT
ZIP 06335
Phone: (860) 464-1040
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DR. JEANETTE JEZICK OD., LLC is an optometrist in Gales Ferry, CT. The provider is doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. DR. JEANETTE JEZICK OD., LLC NPI is 1144556192. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Eyecare Expressions.

The provider's business location address is:

1663 ROUTE 12
GALES FERRY, CT
ZIP 06335-500
Phone: (860) 464-1040
Fax: (860) 464-1044

The provider's authorized official is Peter Wilbanks .
The authorized official title is Manager and has the following contact phone number (860) 464-1040.

The enumeration date for this NPI number is 10/27/2009 and was last updated on 10/27/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1152W00000XOptometrist002353CONNECTICUTYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1004132429MEDICAIDCONNECTICUT
2410000975OTHERCONNECTICUTMEDICARE ID TYPE UNSPECIFIED PTAN
3U46251MEDICARE UPINCONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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