Provider Demographics
NPI:1295939155
Name:B.E.K EYECARE, INC
Entity type:Organization
Organization Name:B.E.K EYECARE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ARMANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:RAFAEL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:203-235-2015
Mailing Address - Street 1:512 W MAIN ST
Mailing Address - Street 2:CASTLE VIEW PLAZA
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06451-2758
Mailing Address - Country:US
Mailing Address - Phone:203-235-2015
Mailing Address - Fax:203-238-1432
Practice Address - Street 1:512 W MAIN ST
Practice Address - Street 2:CASTLE VIEW PLAZA
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06451-2758
Practice Address - Country:US
Practice Address - Phone:203-235-2015
Practice Address - Fax:203-238-1432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1012152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004061248Medicaid
D100047154Medicare PIN
CT004061248Medicaid
CT0474110001Medicare NSC