Provider Demographics
NPI:1689701096
Name:BOSTON EYE CARE CONSULTANTS
Entity Type:Organization
Organization Name:BOSTON EYE CARE CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:LYTLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-771-6447
Mailing Address - Street 1:51 MAIN ST
Mailing Address - Street 2:SUITE 4-5
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-3109
Mailing Address - Country:US
Mailing Address - Phone:508-771-6447
Mailing Address - Fax:508-775-5104
Practice Address - Street 1:51 MAIN ST
Practice Address - Street 2:SUITE 4-5
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-3109
Practice Address - Country:US
Practice Address - Phone:508-771-6447
Practice Address - Fax:508-775-5104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2579152W00000X
MA54395207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1063440881OtherJANET LEMOINE NPI
MD15376OtherPILGRIM
MA1831185099OtherLYTLE NPI
MA711397OtherTUFTS
MA0393762Medicaid
MAAETNAOther4090239
MAM14824OtherBCBS GROUP
MAM14824OtherBCBS GROUP
MA1063440881OtherJANET LEMOINE NPI
MAA57859Medicare UPIN
MAAETNAOther4090239
MA0393762Medicaid