SCOTT LAKE (NPI# 1154587822) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154587822 |
| Entity Type | Individual |
| Full Name | SCOTT LAKE |
| Credential | OD |
| Practice Address |
1 Prestige Dr Suite 107 Meriden CT 06450-7164 |
| Mailing Address |
25 Needham St Newton MA 02461-1615 |
| Practice Telephone | 2036390311 |
| Practice Fax Number | 2036391489 |
| Mailing Telephone | 6179646681 |
| Mailing Fax Number | 6176300141 |
| Enumeration Date | 2008-08-01 |
| Last Update Date | 2008-08-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 002756 | CT | Eye and Vision Services Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033340088 | Scott Anthony Lake | Dentist | 616 E Main, Chewelah, WA 99109 | 2009-08-06 |
| 1487000386 | Scott Andrew Lake | Registered Nurse | 410 W 10th Ave, Columbus, OH 43210-1240 | 2016-05-10 |
| Street Address |
1 PRESTIGE DR SUITE 107 |
| City | MERIDEN |
| State | CT |
| Zip Code | 06450-7164 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720094535 | Audrey Anne Caruthers | Technician/Technologist | 1 Prestige Dr, Suite 107, Meriden, CT 06450-7164 | 2006-08-01 |
| 1437393329 | Arthur C. Embleton | Audiologist | 1 Prestige Dr, Suite 107, Meriden, CT 06450-7164 | 2009-04-23 |
| 1306001789 | Bita Moeinifar | Optometrist | 1 Prestige Dr, Suite 107, Meriden, CT 06450-7164 | 2008-07-24 |
| 1184815136 | Nathaniel Senderoff | Technician/Technologist | 1 Prestige Dr, Meriden, CT 06450-7164 | 2007-08-06 |
| 1144338468 | George Phillip Haas | Dentist | 1 Prestige Dr, Suite #107, Meriden, CT 06450-7164 | 2006-08-27 |
| 1609980945 | Janet Marie Conklin | Dental Hygienist | 1 Prestige Dr, Suite #107, Meriden, CT 06450-7164 | 2006-08-17 |
| 1225142599 | Mel T. Sanchez | Dentist | 1 Prestige Dr, Suite # 107, Meriden, CT 06450-7164 | 2006-08-17 |
| 1811906530 | Susan Rosenbluth Glasman | Podiatrist | 1 Prestige Dr, Suite 107, Meriden, CT 06450-7164 | 2006-08-05 |
| 1053320523 | Carol Helen Kisner-bothwell | Audiologist | 1 Prestige Dr, Suite 107, Meriden, CT 06450-7164 | 2006-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861056525 | Oak Counseling Services LLC | Counselor | Oak Counseling Services, LLC, 97 East Main St. (suite 1h), Meriden, CT 06450 | 2019-04-29 |
| 1467969253 | Midstate Arc | Day Training, Developmentally Disabled Services | 200 Research Pkwy, Meriden, CT 06450 | 2018-01-03 |
| 1144674672 | Felistas Mazhandu | Nurse Practitioner | 53 Church Hill Chase, Meriden, CT 06450 | 2016-04-21 |
| 1639557390 | D J Park PC | Dentist | 490-19 South Broad Street, Meriden, CT 06450 | 2015-05-14 |
| 1912393844 | Elliott Lacki | Psychologist | 1355 N Broad St, Meriden, CT 06450 | 2015-04-07 |
| 1124379797 | Jamie Anne Gargano | Social Worker | 538 Preston Avenue, Meriden, CT 06450 | 2012-09-24 |
| 1760738025 | Psychologist Adriana L Gonzalez Phd Pllc | Clinic/Center | 85 Hillcrest Terrace, Meriden, CT 06450 | 2012-07-24 |
| 1174888622 | Dong Jin Park | Dentist | 490 S Broad St, Meriden, CT 06450 | 2012-07-11 |
| 1710253182 | Adriana Laura Gonzalez | Psychologist | 85 Hillcrest Ter, Meriden, CT 06450 | 2012-03-29 |
| 1285864199 | Crystal Ann Herdman | Occupational Therapist | 33 Cone Avenue, Meriden, CT 06450 | 2009-07-27 |
| Find all providers in zip 06450 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| 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. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801330691 | Premier Eyecare of Meriden LLC. | Optometrist | 35 Pleasant St Ste 2c, Meriden, CT 06450-7596 | 2016-12-13 |
| 1659695344 | Dr. Bertolli Od & Associates LLC | Optometrist | 470 Lewis Avenue, C/o Sears Optical, Meriden, CT 06451 | 2010-03-24 |
| 1881805208 | Dr.aucello & Associates, P.C. | Optometrist | 470 Lewis Ave Ste 39, Meriden, CT 06451-2103 | 2007-05-25 |
| 1902835713 | Monique L Dawson | Optometrist | 533 S Broad St, Meriden, CT 06450-6661 | 2006-07-02 |
| 1558349738 | Craig Lawrence Nielsen | Optometrist | 105 Broad St, Meriden, CT 06450-6516 | 2006-01-06 |
| 1174524896 | John Biestek | Optometrist | 35 Pleasent St, Suite 2c, Meriden, CT 06450 | 2005-08-03 |
| 1922668342 | Rachel Hillary Swaniger | Optometrist | 512 W Main St, Meriden, CT 06451-2758 | 2019-06-18 |
| 1205297058 | Insight, LLC | Optometrist | 470 Lewis Ave, Meriden, CT 06451-2103 | 2016-03-08 |
| 1841674520 | Meriden Eye Care, LLC | Optometrist | 816 Broad St, Ste 13, Meriden, CT 06450-4350 | 2015-07-13 |
| 1629209150 | Mark Francis Di Loreto | Optometrist | 512 W Main St, B.e.k Eyecare Inc, Meriden, CT 06451-2758 | 2009-07-31 |
| Find all providers in MERIDEN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.