Provider Demographics
NPI:1073773487
Name:HARBOR VIEW EYE CARE, LLC
Entity Type:Organization
Organization Name:HARBOR VIEW EYE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:D
Authorized Official - Last Name:HEWARD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:207-799-3031
Mailing Address - Street 1:743 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-4419
Mailing Address - Country:US
Mailing Address - Phone:207-799-3031
Mailing Address - Fax:207-799-9005
Practice Address - Street 1:743 BROADWAY
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-4419
Practice Address - Country:US
Practice Address - Phone:207-799-3031
Practice Address - Fax:207-799-9005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-10
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1760441042OtherKRISHNA KRITHIVAS NPI#
ME1851356588OtherDAVID HEWARD OD NPI #
ME1760441042OtherKRISHNA KRITHIVAS NPI#
MEDP3562Medicare PIN
ME0551340001Medicare NSC
ME1851356588OtherDAVID HEWARD OD NPI #