Provider Demographics
NPI:1871006197
Name:BOSTON EYE CARE CENTER,LLC
Entity Type:Organization
Organization Name:BOSTON EYE CARE CENTER,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:S
Authorized Official - Last Name:YING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-657-9464
Mailing Address - Street 1:5 JFK ST STE 302
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-4916
Mailing Address - Country:US
Mailing Address - Phone:617-657-9464
Mailing Address - Fax:617-491-0470
Practice Address - Street 1:5 JFK ST STE 302
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-4916
Practice Address - Country:US
Practice Address - Phone:617-657-9464
Practice Address - Fax:617-491-0470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-08
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA261272207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110128931AMedicaid