Provider Demographics
NPI:1255542882
Name:FALCK EYE CENTERS, L.L.C.
Entity type:Organization
Organization Name:FALCK EYE CENTERS, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPHTHALMOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:Y
Authorized Official - Last Name:FALCK
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD, PHD, MS
Authorized Official - Phone:860-857-2020
Mailing Address - Street 1:35 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:MYSTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06355-2816
Mailing Address - Country:US
Mailing Address - Phone:860-572-2020
Mailing Address - Fax:860-572-2000
Practice Address - Street 1:35 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MYSTIC
Practice Address - State:CT
Practice Address - Zip Code:06355-2816
Practice Address - Country:US
Practice Address - Phone:860-572-2020
Practice Address - Fax:860-572-2000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT033284174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT=========OtherSOCIAL SECURITY
CTF24072Medicare UPIN