Provider Demographics
NPI:1821612409
Name:NEW GARDEN EYE CARE OD PLLC
Entity Type:Organization
Organization Name:NEW GARDEN EYE CARE OD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:ABLOTT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:402-984-0454
Mailing Address - Street 1:5835 GREEN MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-2505
Mailing Address - Country:US
Mailing Address - Phone:336-314-0747
Mailing Address - Fax:
Practice Address - Street 1:3707 BATTLEGROUND AVE STE C
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-2543
Practice Address - Country:US
Practice Address - Phone:336-314-0747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-30
Last Update Date:2020-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty