Provider Demographics
NPI:1760655591
Name:ALL EYE CARE, PC
Entity Type:Organization
Organization Name:ALL EYE CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TATYANA
Authorized Official - Middle Name:
Authorized Official - Last Name:KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:339-440-5105
Mailing Address - Street 1:423 PARADISE RD
Mailing Address - Street 2:
Mailing Address - City:SWAMPSCOTT
Mailing Address - State:MA
Mailing Address - Zip Code:01907-1333
Mailing Address - Country:US
Mailing Address - Phone:339-440-5105
Mailing Address - Fax:339-440-5015
Practice Address - Street 1:423 PARADISE RD
Practice Address - Street 2:
Practice Address - City:SWAMPSCOTT
Practice Address - State:MA
Practice Address - Zip Code:01907-1333
Practice Address - Country:US
Practice Address - Phone:339-440-5105
Practice Address - Fax:339-440-5015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-14
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA4576152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0709158Medicaid
MAW1765602Medicare PIN
MAV10905Medicare UPIN
MA0709158Medicaid