Provider Demographics
NPI:1134327836
Name:NEW ENGLAND EYEWORKS LLC
Entity Type:Organization
Organization Name:NEW ENGLAND EYEWORKS LLC
Other - Org Name:VINCENT P. MCMAHON OD
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OPTOMETRIST & OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:P
Authorized Official - Last Name:MCMAHON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:603-352-7803
Mailing Address - Street 1:474 WEST ST
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-2453
Mailing Address - Country:US
Mailing Address - Phone:603-352-7803
Mailing Address - Fax:603-358-6711
Practice Address - Street 1:474 WEST ST
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-2453
Practice Address - Country:US
Practice Address - Phone:603-352-7803
Practice Address - Fax:603-358-6711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-05
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHNH323152W00000X
NH0384225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0472910001Medicare NSC
NH0004074Medicare PIN
NH6127910001Medicare NSC