Provider Demographics
NPI:1679018279
Name:PHYSICIANS EYE CARE, LLC.
Entity Type:Organization
Organization Name:PHYSICIANS EYE CARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAHNAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:NOURI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-251-8891
Mailing Address - Street 1:250 HAMMOND POND PKWY
Mailing Address - Street 2:UNIT 505 NORTH
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-1533
Mailing Address - Country:US
Mailing Address - Phone:617-251-8891
Mailing Address - Fax:617-332-7132
Practice Address - Street 1:250 HAMMOND POND PKWY
Practice Address - Street 2:UNIT 505 NORTH
Practice Address - City:CHESTNUT HILL
Practice Address - State:MA
Practice Address - Zip Code:02467-1533
Practice Address - Country:US
Practice Address - Phone:617-251-8891
Practice Address - Fax:617-332-7132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-05
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty