Provider Demographics
NPI:1376660852
Name:PATTI A RICHARD DBA FAMILY EYE CARE
Entity Type:Organization
Organization Name:PATTI A RICHARD DBA FAMILY EYE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROP
Authorized Official - Prefix:
Authorized Official - First Name:PATTI
Authorized Official - Middle Name:A
Authorized Official - Last Name:RICHARD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:978-681-1111
Mailing Address - Street 1:555 TURNPIKE ST
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-5923
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:555 TURNPIKE ST
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-5923
Practice Address - Country:US
Practice Address - Phone:978-681-1111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA691390OtherTUFTS
MAW20170OtherBCBS