Provider Demographics
NPI:1467577759
Name:SALEM EYE ASSOCIATES
Entity Type:Organization
Organization Name:SALEM EYE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:T
Authorized Official - Last Name:MCHUGH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:978-744-2675
Mailing Address - Street 1:197 LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-4739
Mailing Address - Country:US
Mailing Address - Phone:978-744-2675
Mailing Address - Fax:978-744-8982
Practice Address - Street 1:197 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-4739
Practice Address - Country:US
Practice Address - Phone:978-744-2675
Practice Address - Fax:978-744-8982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3114152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAT59428OtherHARVARD PILGRIM
MAW15660OtherBCBS
MA024448511OtherUNICARE
MA0353213Medicaid
MD0807274OtherAETNA
MA2200334OtherUNITED HEALTHCARE
MA705219OtherTUFTS
MA7747OtherDAVIS
MA113976OtherEYEMED
MA0006052OtherNEIGHBORHOOD HEALTH
MA024448511OtherPHCS
MAT59428OtherHARVARD PILGRIM
MD0807274OtherAETNA
MA413558Medicare ID - Type Unspecified