Provider Demographics
NPI:1043377211
Name:MIDDLESEX EYE PHYSICIANS P.C.
Entity Type:Organization
Organization Name:MIDDLESEX EYE PHYSICIANS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-347-7466
Mailing Address - Street 1:400 SAYBROOK RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-4773
Mailing Address - Country:US
Mailing Address - Phone:860-347-7466
Mailing Address - Fax:860-347-2619
Practice Address - Street 1:400 SAYBROOK RD
Practice Address - Street 2:SUITE 100
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-4773
Practice Address - Country:US
Practice Address - Phone:860-347-7466
Practice Address - Fax:860-347-2619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT3927230001Medicare NSC