Provider Demographics
NPI:1659347508
Name:EYE ASSOCIATES OF NORTHERN NEW ENGLAND, LLP
Entity Type:Organization
Organization Name:EYE ASSOCIATES OF NORTHERN NEW ENGLAND, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:PHIPPS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:802-748-8126
Mailing Address - Street 1:1290 HOSPITAL DR
Mailing Address - Street 2:SUITE 5
Mailing Address - City:ST JOHNSBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05819-9239
Mailing Address - Country:US
Mailing Address - Phone:802-748-8126
Mailing Address - Fax:802-748-2208
Practice Address - Street 1:1290 HOSPITAL DR
Practice Address - Street 2:SUITE 5
Practice Address - City:ST JOHNSBURY
Practice Address - State:VT
Practice Address - Zip Code:05819-9239
Practice Address - Country:US
Practice Address - Phone:802-748-8126
Practice Address - Fax:802-748-2208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-28
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30212883Medicaid
VT1010527Medicaid
VT1010527Medicaid
NHRE7646Medicare ID - Type Unspecified