Provider Demographics
NPI:1467677039
Name:CAPITAL EYES OPHTHALMOLOGY INC
Entity Type:Organization
Organization Name:CAPITAL EYES OPHTHALMOLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MIRFEE
Authorized Official - Middle Name:K
Authorized Official - Last Name:UNGIER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-743-7456
Mailing Address - Street 1:6820 RIDGE RD
Mailing Address - Street 2:#102
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44129-5646
Mailing Address - Country:US
Mailing Address - Phone:440-743-7456
Mailing Address - Fax:440-743-7459
Practice Address - Street 1:6820 RIDGE RD
Practice Address - Street 2:#102
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-5646
Practice Address - Country:US
Practice Address - Phone:440-743-7456
Practice Address - Fax:440-743-7459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35 045261207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH27746664600Medicaid
OHUN0550323Medicare ID - Type Unspecified
OH27746664600Medicaid