Provider Demographics
NPI:1255431474
Name:KEAMY EYE & LASER CENTRE LLC
Entity type:Organization
Organization Name:KEAMY EYE & LASER CENTRE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:KEAMY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-836-8733
Mailing Address - Street 1:24 LYMAN ST
Mailing Address - Street 2:SUITE 130
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-1482
Mailing Address - Country:US
Mailing Address - Phone:508-836-8733
Mailing Address - Fax:
Practice Address - Street 1:24 LYMAN ST
Practice Address - Street 2:SUITE 130
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-1482
Practice Address - Country:US
Practice Address - Phone:508-836-8733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA204780207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9738401Medicaid
MA9738401Medicaid
MAH46012Medicare UPIN