Provider Demographics
NPI:1083735351
Name:SOUTH SHORE EYE ASSOCIATES PC
Entity Type:Organization
Organization Name:SOUTH SHORE EYE ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:H
Authorized Official - Last Name:FREEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:508-238-8460
Mailing Address - Street 1:670 DEPOT ST
Mailing Address - Street 2:PO BOX 1100
Mailing Address - City:EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02334-9800
Mailing Address - Country:US
Mailing Address - Phone:508-238-8460
Mailing Address - Fax:508-238-8468
Practice Address - Street 1:670 DEPOT ST
Practice Address - Street 2:
Practice Address - City:NORTH EASTON
Practice Address - State:MA
Practice Address - Zip Code:02356-2742
Practice Address - Country:US
Practice Address - Phone:508-238-8460
Practice Address - Fax:508-238-8468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2384152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0034244OtherAETNA-U S HEALTHCARE
MAW20019OtherHMO BLUE
MAW20019OtherHMO BLUE