Provider Demographics
NPI:1811633944
Name:OPTOMETRY ONSITE NEW ENGLAND PLLC
Entity type:Organization
Organization Name:OPTOMETRY ONSITE NEW ENGLAND PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMY
Authorized Official - Middle Name:VAN WYCK
Authorized Official - Last Name:BORBIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:603-568-9257
Mailing Address - Street 1:11 WINDSOR RD
Mailing Address - Street 2:
Mailing Address - City:BOW
Mailing Address - State:NH
Mailing Address - Zip Code:03304-5218
Mailing Address - Country:US
Mailing Address - Phone:603-568-9257
Mailing Address - Fax:
Practice Address - Street 1:11 WINDSOR RD
Practice Address - Street 2:
Practice Address - City:BOW
Practice Address - State:NH
Practice Address - Zip Code:03304-5218
Practice Address - Country:US
Practice Address - Phone:603-568-9257
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-11
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health