Provider Demographics
NPI:1306400478
Name:VALENTINE EYE GROUP
Entity Type:Organization
Organization Name:VALENTINE EYE GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:VALENTINE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:978-502-9434
Mailing Address - Street 1:80 ERDMAN WAY # 205
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-1840
Mailing Address - Country:US
Mailing Address - Phone:978-696-5674
Mailing Address - Fax:867-400-7836
Practice Address - Street 1:80 ERDMAN WAY # 205
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-1840
Practice Address - Country:US
Practice Address - Phone:978-696-5674
Practice Address - Fax:978-400-7836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-24
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty