Provider Demographics
NPI:1821106998
Name:CHARLES RIVER EYE ASSOCIATES
Entity Type:Organization
Organization Name:CHARLES RIVER EYE ASSOCIATES
Other - Org Name:JACK V GREINER DBA CHARLES RIVER EYE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:V
Authorized Official - Last Name:GREINER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:617-248-3875
Mailing Address - Street 1:5 WHITTIER PLACE
Mailing Address - Street 2:SUITE #102
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-1429
Mailing Address - Country:US
Mailing Address - Phone:617-248-3875
Mailing Address - Fax:617-248-0276
Practice Address - Street 1:5 WHITTIER PLACE
Practice Address - Street 2:SUITE #102
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-1429
Practice Address - Country:US
Practice Address - Phone:617-248-3875
Practice Address - Fax:617-248-0276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty