Provider Demographics
NPI:1194833467
Name:TALLMAN EYE ASSOCIATES, PC
Entity Type:Organization
Organization Name:TALLMAN EYE ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-688-6182
Mailing Address - Street 1:360 MERRIMACK ST
Mailing Address - Street 2:BLDG 9, ENTRANCE I
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-1764
Mailing Address - Country:US
Mailing Address - Phone:978-688-6182
Mailing Address - Fax:978-689-0731
Practice Address - Street 1:360 MERRIMACK ST
Practice Address - Street 2:BLDG 9, ENTRANCE I
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-1764
Practice Address - Country:US
Practice Address - Phone:978-688-6182
Practice Address - Fax:978-689-0731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9713735Medicaid
NH99009525Medicaid
NH99009525Medicaid
NHRE4414Medicare PIN