Provider Demographics
NPI:1033819818
Name:LEXINGTON EYE ASSOCIATES - OPTICAL
Entity Type:Organization
Organization Name:LEXINGTON EYE ASSOCIATES - OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:KILPATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-862-1620
Mailing Address - Street 1:21 WORTHEN RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-4835
Mailing Address - Country:US
Mailing Address - Phone:781-862-1620
Mailing Address - Fax:781-863-9416
Practice Address - Street 1:980 WASHINGTON ST STE 120
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-6704
Practice Address - Country:US
Practice Address - Phone:781-876-2020
Practice Address - Fax:781-863-9416
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LEXINGTON EYE ASSOCIATES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-03-09
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty