Provider Demographics
NPI:1508964370
Name:NORTHERN OHIO EYE CENTER, INC.
Entity Type:Organization
Organization Name:NORTHERN OHIO EYE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:PAJKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-886-2020
Mailing Address - Street 1:6355 PEARL RD
Mailing Address - Street 2:
Mailing Address - City:PARMA HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-3000
Mailing Address - Country:US
Mailing Address - Phone:440-886-2020
Mailing Address - Fax:440-886-2779
Practice Address - Street 1:6355 PEARL RD
Practice Address - Street 2:
Practice Address - City:PARMA HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-3000
Practice Address - Country:US
Practice Address - Phone:440-886-2020
Practice Address - Fax:440-886-2779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35063646207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH180037555OtherRAILROAD MEDICARE
OH0801268OtherUNITED HEALTH CARE
OH284501448006OtherMEDICAL MUTUAL OF OHIO
OH000000141636OtherANTHEM BLUE CROSS/BLUE SH
OH0858844Medicaid
OH284501448006OtherMEDICAL MUTUAL OF OHIO
OH=========-00OtherBUREAU OF WORKER'S COMP
OH9325981Medicare ID - Type Unspecified