Provider Demographics
NPI:1467862383
Name:EYE CARE ASSOCIATES OF GROTON LLC
Entity Type:Organization
Organization Name:EYE CARE ASSOCIATES OF GROTON LLC
Other - Org Name:EYE CARE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:T
Authorized Official - Last Name:BOREY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:860-445-2200
Mailing Address - Street 1:258 ROUTE 12
Mailing Address - Street 2:STE 3
Mailing Address - City:GROTON
Mailing Address - State:CT
Mailing Address - Zip Code:06340-3415
Mailing Address - Country:US
Mailing Address - Phone:860-445-2200
Mailing Address - Fax:860-445-2233
Practice Address - Street 1:258 ROUTE 12
Practice Address - Street 2:STE 3
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06340-3415
Practice Address - Country:US
Practice Address - Phone:860-445-2200
Practice Address - Fax:860-445-2233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-30
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty