Provider Demographics
NPI:1154505675
Name:NEILL S COWLES
Entity Type:Organization
Organization Name:NEILL S COWLES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NEILL
Authorized Official - Middle Name:S
Authorized Official - Last Name:COWLES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:508-255-0510
Mailing Address - Street 1:259 CROWELL RD
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02633-1969
Mailing Address - Country:US
Mailing Address - Phone:508-945-2552
Mailing Address - Fax:
Practice Address - Street 1:259 CROWELL RD
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:MA
Practice Address - Zip Code:02633-1969
Practice Address - Country:US
Practice Address - Phone:508-945-2552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2185152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0135710001Medicare NSC