Provider Demographics
NPI:1467649715
Name:CENTER FOR EYE EXCELLENCE
Entity Type:Organization
Organization Name:CENTER FOR EYE EXCELLENCE
Other - Org Name:PAPALE EYE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:PAPALE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:413-782-0030
Mailing Address - Street 1:1515 ALLEN ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01118-1803
Mailing Address - Country:US
Mailing Address - Phone:413-782-0030
Mailing Address - Fax:413-796-1985
Practice Address - Street 1:1515 ALLEN ST
Practice Address - Street 2:SUITE E
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01118-1803
Practice Address - Country:US
Practice Address - Phone:413-782-0030
Practice Address - Fax:413-796-1985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA46264207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3067874Medicaid
MA2115964Medicaid
MAA57880Medicare UPIN
MA2115964Medicaid