Provider Demographics
NPI:1558539551
Name:THOMAS P. NADEAU,O.D.,P.C.
Entity Type:Organization
Organization Name:THOMAS P. NADEAU,O.D.,P.C.
Other - Org Name:SHEEPSCOT EYE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:P
Authorized Official - Last Name:NADEAU
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:207-633-3035
Mailing Address - Street 1:PO BOX 455
Mailing Address - Street 2:
Mailing Address - City:BOOTHBAY HARBOR
Mailing Address - State:ME
Mailing Address - Zip Code:04538-0455
Mailing Address - Country:US
Mailing Address - Phone:207-633-3035
Mailing Address - Fax:207-633-6079
Practice Address - Street 1:145 TOWNSEND AVE
Practice Address - Street 2:
Practice Address - City:BOOTHBAY HARBOR
Practice Address - State:ME
Practice Address - Zip Code:04538-1845
Practice Address - Country:US
Practice Address - Phone:207-633-3035
Practice Address - Fax:207-633-6079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOPT603332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME0174690001Medicare NSC