Provider Demographics
NPI:1750461836
Name:EYE CARE ASSOCIATES
Entity Type:Organization
Organization Name:EYE CARE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:N
Authorized Official - Last Name:KLINE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:203-758-6644
Mailing Address - Street 1:PO BOX 7035
Mailing Address - Street 2:67 WATERBURY ROAD
Mailing Address - City:PROSPECT
Mailing Address - State:CT
Mailing Address - Zip Code:06712
Mailing Address - Country:US
Mailing Address - Phone:203-758-6644
Mailing Address - Fax:203-758-0429
Practice Address - Street 1:67 WATERBURY ROAD
Practice Address - Street 2:
Practice Address - City:PROSPECT
Practice Address - State:CT
Practice Address - Zip Code:06712
Practice Address - Country:US
Practice Address - Phone:203-758-6644
Practice Address - Fax:203-758-0429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
090000688CTOtherANTHEM
OVO488OtherHEALTH NET
2037586644OtherEYEFINITY ACCESS ID
688CTOtherSTATE LICENSE
CT004023610Medicaid
006680OtherCONNECTICARE
046241852OtherVSP DOCTOR ID
P384396OtherOXFORD
P384396OtherOXFORD
P384396OtherOXFORD
CT410000199Medicare ID - Type Unspecified
CT004023610Medicaid