Provider Demographics
NPI:1114179223
Name:SIKALIS EYE ASSOCIATES
Entity Type:Organization
Organization Name:SIKALIS EYE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SIKALIS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:978-452-0127
Mailing Address - Street 1:850 CHELMSFORD ST
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01851-5149
Mailing Address - Country:US
Mailing Address - Phone:978-452-0127
Mailing Address - Fax:
Practice Address - Street 1:850 CHELMSFORD ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01851-5149
Practice Address - Country:US
Practice Address - Phone:978-452-0127
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3120152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
152048OtherHARVARD PILGRIM
W15832OtherBLUE CROSS BLUE SHIELD
MA0353639Medicaid
997540OtherNETWORK HEALTH
MA0353639Medicaid