Provider Demographics
NPI:1699810226
Name:URBAN EYE MD ASSOCIATES, P.C
Entity Type:Organization
Organization Name:URBAN EYE MD ASSOCIATES, P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMIN
Authorized Official - Prefix:MISS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:V
Authorized Official - Last Name:SCANTLEBURY
Authorized Official - Suffix:
Authorized Official - Credentials:COT,MA
Authorized Official - Phone:617-262-6300
Mailing Address - Street 1:720 HARRISON AVE
Mailing Address - Street 2:SUITE 701
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2371
Mailing Address - Country:US
Mailing Address - Phone:617-262-6300
Mailing Address - Fax:617-262-6301
Practice Address - Street 1:720 HARRISON AVE
Practice Address - Street 2:SUITE 701
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2371
Practice Address - Country:US
Practice Address - Phone:617-262-6300
Practice Address - Fax:617-262-6301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9710876Medicaid
MAM17887OtherBCBS GROUP NUMBER
MAM10247Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER