Provider Demographics
NPI:1225004955
Name:THE MEDICAL EYE CENTER, P.C.
Entity Type:Organization
Organization Name:THE MEDICAL EYE CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:SHAKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-668-2020
Mailing Address - Street 1:250 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-2423
Mailing Address - Country:US
Mailing Address - Phone:603-668-2020
Mailing Address - Fax:603-668-0881
Practice Address - Street 1:250 RIVER RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-2423
Practice Address - Country:US
Practice Address - Phone:603-668-2020
Practice Address - Fax:603-668-0881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-23
Last Update Date:2017-07-21
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
NHRE2722Medicare PIN