Provider Demographics
NPI:1356843890
Name:FAMILY EYECARE SOLUTIONS LLC
Entity Type:Organization
Organization Name:FAMILY EYECARE SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:VASILAKOS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:781-829-9400
Mailing Address - Street 1:51 MILL ST BLDG E
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MA
Mailing Address - Zip Code:02339-1641
Mailing Address - Country:US
Mailing Address - Phone:781-829-9400
Mailing Address - Fax:781-829-9401
Practice Address - Street 1:51 MILL ST BLDG E
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MA
Practice Address - Zip Code:02339-1641
Practice Address - Country:US
Practice Address - Phone:781-829-9400
Practice Address - Fax:781-829-9401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-01
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4553261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service