Provider Demographics
NPI:1134155419
Name:CAMBRIDGE EYE ASSOCIATES, P.A.
Entity type:Organization
Organization Name:CAMBRIDGE EYE ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHADWICK
Authorized Official - Middle Name:AARON
Authorized Official - Last Name:CHRISTENSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:763-689-1494
Mailing Address - Street 1:120 1ST AVE E
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MN
Mailing Address - Zip Code:55008-1209
Mailing Address - Country:US
Mailing Address - Phone:763-689-1494
Mailing Address - Fax:763-691-8395
Practice Address - Street 1:120 1ST AVE E
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MN
Practice Address - Zip Code:55008-1209
Practice Address - Country:US
Practice Address - Phone:763-689-1494
Practice Address - Fax:763-691-8395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN159D7CAOtherBLUECROSS BLUESHIELD DME
MN2100251OtherMEDICA DME
MN64G30CAOtherBLUE CROSS BLUE SHIELD
MN42955OtherPREFERRED ONE
MN86176OtherHEALTHPARTNERS
MN337778400Medicaid
C03148Medicare ID - Type Unspecified
MN86176OtherHEALTHPARTNERS
CJ9925Medicare ID - Type UnspecifiedRAILROAD MEDICARE