Provider Demographics
NPI:1699746040
Name:SITES, FRANCES (OD)
Entity type:Individual
Prefix:
First Name:FRANCES
Middle Name:
Last Name:SITES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 MAIN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:CT
Mailing Address - Zip Code:06422-2116
Mailing Address - Country:US
Mailing Address - Phone:860-349-2323
Mailing Address - Fax:860-349-2313
Practice Address - Street 1:16 MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:CT
Practice Address - Zip Code:06422-2116
Practice Address - Country:US
Practice Address - Phone:860-349-2323
Practice Address - Fax:860-349-2313
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002303152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTU127066Medicaid
U30914Medicare UPIN
CTU100Medicare ID - Type Unspecified