Provider Demographics
NPI:1720121858
Name:EYE MDS OF GREATER BOSTON, PC
Entity Type:Organization
Organization Name:EYE MDS OF GREATER BOSTON, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLIOT
Authorized Official - Middle Name:
Authorized Official - Last Name:FINKELSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-734-8090
Mailing Address - Street 1:1371 BEACON ST
Mailing Address - Street 2:100
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-4905
Mailing Address - Country:US
Mailing Address - Phone:617-734-8090
Mailing Address - Fax:617-738-4224
Practice Address - Street 1:1371 BEACON ST
Practice Address - Street 2:100
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-4905
Practice Address - Country:US
Practice Address - Phone:617-734-8090
Practice Address - Fax:617-738-4224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9758496Medicaid
MAA37489Medicare UPIN
MAM14839Medicare ID - Type Unspecified