Provider Demographics
NPI:1083805709
Name:DR STEVEN P LARY
Entity Type:Organization
Organization Name:DR STEVEN P LARY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:LARY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:207-236-3429
Mailing Address - Street 1:PO BOX 597
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:ME
Mailing Address - Zip Code:04843-0597
Mailing Address - Country:US
Mailing Address - Phone:207-236-3429
Mailing Address - Fax:
Practice Address - Street 1:38 CURTIS AVE
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:ME
Practice Address - Zip Code:04843-2008
Practice Address - Country:US
Practice Address - Phone:207-236-3429
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEMM5082Medicare PIN
ME0681700001Medicare NSC