Provider Demographics
NPI:1821155607
Name:NEWTONEYE PC
Entity Type:Organization
Organization Name:NEWTONEYE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:WITTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:617-332-1471
Mailing Address - Street 1:ONE WASHINGTON STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481
Mailing Address - Country:US
Mailing Address - Phone:617-332-1471
Mailing Address - Fax:617-332-2735
Practice Address - Street 1:ONE WASHINGTON STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481
Practice Address - Country:US
Practice Address - Phone:617-332-1471
Practice Address - Fax:617-332-2735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
602279OtherTUFTS
MA9738291Medicaid
0035202OtherNHP
MAW20361OtherBCBS
MAW21091Medicare PIN
MA9738291Medicaid