Provider Demographics
NPI:1942203351
Name:ASPEN ENTERPRISES INC
Entity Type:Organization
Organization Name:ASPEN ENTERPRISES INC
Other - Org Name:SPRINGFIELD OPTOMETRIC ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:A
Authorized Official - Last Name:FLEISHER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:413-782-5339
Mailing Address - Street 1:1268 SUMNER AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01118-1770
Mailing Address - Country:US
Mailing Address - Phone:413-782-5339
Mailing Address - Fax:413-782-3050
Practice Address - Street 1:1268 SUMNER AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01118-1770
Practice Address - Country:US
Practice Address - Phone:413-782-5339
Practice Address - Fax:413-782-3050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA694131Other694131
MA9711830Medicaid
MADA1284OtherRAILROAD MEDICARE
MA0024830OtherNIEGHBORHOOD HEALTH PLAN
MAW20340OtherBLUE CROSS BLUE SCHIELD
MA9711830Medicaid