Fedora, Peter John
Fedora, Peter John is an sole proprietor health care provider with primary practice located at 236 N Main St , Manchester CT 06042-2004. He recently has only one registered license in Eye and Vision Services Providers / Optician, which is considered as his primary health care specialty. Fedora, Peter John can be contacted via phone (860) 646-3577.Contact Information
Primary practice address
236 N Main St
Manchester CT 06042-2004
Phone: (860) 646-3577
Fax: (860) 643-9733
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optician | 156FX1800X | 000601 | Connecticut |
Profile Details
| NPI number | 1659493021 |
|---|---|
| LBN Legal business name | Fedora, Peter John |
| Credentials | L.O. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 4th, 2007 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659493021 | NPPES |
| Connecticut | Other | 06-1198912 | FEDERAL TAXPAYER ID |
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