Provider Demographics
NPI:1346437779
Name:EYE PHYSICIANS OF NORTHAMPTON
Entity Type:Organization
Organization Name:EYE PHYSICIANS OF NORTHAMPTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:S
Authorized Official - Last Name:BLEIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:413-584-6422
Mailing Address - Street 1:40 MAIN STREET
Mailing Address - Street 2:SUITE 6
Mailing Address - City:FLORENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01062
Mailing Address - Country:US
Mailing Address - Phone:413-584-6422
Mailing Address - Fax:413-584-4346
Practice Address - Street 1:40 MAIN STREET
Practice Address - Street 2:SUITE 6
Practice Address - City:FLORENCE
Practice Address - State:MA
Practice Address - Zip Code:01062
Practice Address - Country:US
Practice Address - Phone:413-584-6422
Practice Address - Fax:413-584-4346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2727152W00000X
MA3224152W00000X
152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0327320001OtherDMERC
MAT59382Medicare UPIN
MA0327320001OtherDMERC
MAU82624Medicare UPIN