Provider Demographics
NPI: | 1013155597 |
---|---|
Name: | MASSACHUSETTS EYE AND EAR INFIRMARY |
Entity Type: | Organization |
Organization Name: | MASSACHUSETTS EYE AND EAR INFIRMARY |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | DIRECTOR FINANCE |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | EARL |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | CURRAN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 617-398-2974 |
Mailing Address - Street 1: | 243 CHARLES ST |
Mailing Address - Street 2: | |
Mailing Address - City: | BOSTON |
Mailing Address - State: | MA |
Mailing Address - Zip Code: | 02114-3096 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 617-523-7900 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 243 CHARLES ST |
Practice Address - Street 2: | |
Practice Address - City: | BOSTON |
Practice Address - State: | MA |
Practice Address - Zip Code: | 02114-3002 |
Practice Address - Country: | US |
Practice Address - Phone: | 617-573-3182 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2009-01-22 |
Last Update Date: | 2023-04-03 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 332H00000X | Suppliers | Eyewear Supplier |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
MA | 1201158 | Medicaid | |
MA | 0598070001 | Medicare NSC | |
1639101751 | Medicare NSC |