Provider Demographics
NPI:1508899287
Name:NUTFIELD OPHTHALMOLOGY, PC
Entity Type:Organization
Organization Name:NUTFIELD OPHTHALMOLOGY, PC
Other - Org Name:NUTFIELD EYE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:COCOZZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-434-3937
Mailing Address - Street 1:3 ORCHARD VIEW DR
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-6606
Mailing Address - Country:US
Mailing Address - Phone:603-421-0022
Mailing Address - Fax:603-421-0259
Practice Address - Street 1:3 ORCHARD VIEW DR
Practice Address - Street 2:
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-6606
Practice Address - Country:US
Practice Address - Phone:603-421-0022
Practice Address - Fax:603-421-0259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30216545Medicaid
NH4500140001Medicare NSC
NHRE8753Medicare PIN