MEDICARE: NORTHEAST EYE CARE ASSOCIATES, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist

General Provider Information

NPI Number	:	1568495349
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHEAST EYE CARE ASSOCIATES, PC

Provider Business Mailing Address
First Line	:	PO BOX 428
Second Line	:
City	:	DEERFIELD
State	:	NH
Zip	:	03037-0428
Country	:	US
Telephone Number	:	603-463-7373
Fax Number	:	603-463-7390

Provider Business Practice Location Address
First Line	:	45 NORTH RD
Second Line	:
City	:	DEERFIELD
State	:	NH
Zip	:	03037-1400
Country	:	US
Telephone Number	:	603-463-7373
Fax Number	:	603-463-7390

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SUSAN FISCHER
Credential	:
Telephone Number	:	603-964-9340

Provider Enumeration Date	:	07/08/2006
Last Update Date	:	03/04/2020

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