Provider Demographics
NPI:1336447523
Name:PUZIO EYECARE ASSOCIATES, LLC
Entity Type:Organization
Organization Name:PUZIO EYECARE ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:D
Authorized Official - Last Name:PUZIO
Authorized Official - Suffix:
Authorized Official - Credentials:OD, FAAO
Authorized Official - Phone:508-394-2211
Mailing Address - Street 1:P.O. BOX 1661
Mailing Address - Street 2:
Mailing Address - City:EAST HARWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02645-1661
Mailing Address - Country:US
Mailing Address - Phone:508-432-3444
Mailing Address - Fax:508-432-3401
Practice Address - Street 1:119 B ROUTE 137
Practice Address - Street 2:
Practice Address - City:EAST HARWICH
Practice Address - State:MA
Practice Address - Zip Code:02645-2153
Practice Address - Country:US
Practice Address - Phone:508-432-3444
Practice Address - Fax:508-432-3401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-11
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0019791Medicare UPIN