Lertora, John Mark

Lertora, John Mark is an individual health care provider with primary practice located at 38 Tunxis Ave Suite 1, Bloomfield CT 06002-2034. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Lertora, John Mark can be contacted via phone (860) 243-2508.

Contact Information

Primary practice address
38 Tunxis Ave Suite 1 Bloomfield CT 06002-2034
Fax: (860) 243-9332
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 002069 Connecticut

Profile Details

NPI number 1780657213
LBN Legal business name Lertora, John Mark
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 7th, 2006
Last updated Oct 25th, 2022 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780657213 NPPES
Connecticut MEDICAID 004065280

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