1932160504 NPI number — EYE PHYSICIANS OF NORTHAMPTON, PC

Table of content: (NPI 1932160504)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932160504 NPI number — EYE PHYSICIANS OF NORTHAMPTON, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EYE PHYSICIANS OF NORTHAMPTON, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932160504
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/27/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
40 MAIN ST
Provider Second Line Business Mailing Address:
SUITE 106
Provider Business Mailing Address City Name:
FLORENCE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01062-3100
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-584-6422
Provider Business Mailing Address Fax Number:
413-584-4346

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
40 MAIN ST
Provider Second Line Business Practice Location Address:
SUITE 106
Provider Business Practice Location Address City Name:
FLORENCE
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01062-3100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-584-6422
Provider Business Practice Location Address Fax Number:
413-584-4346
Provider Enumeration Date:
03/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BLEIMAN
Authorized Official First Name:
BRUCE
Authorized Official Middle Name:
S.
Authorized Official Title or Position:
OWNER/PARTNER
Authorized Official Telephone Number:
413-584-6422

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 379460 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 709455 . This is a "TUFTS HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: CK0668 . This is a "MEDICARE RR" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 9727884 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: M11749 . This is a "BLUE CROSS BLUE SHIELD MA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com