Healthcare Provider Details

I. General information

NPI: 1790789741
Provider Name (Legal Business Name): EYE ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2005
Last Update Date: 12/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

172 CAMBRIDGE ST
BURLINGTON MA
01803-2984
US

IV. Provider business mailing address

172 CAMBRIDGE ST
BURLINGTON MA
01803-2984
US

V. Phone/Fax

Practice location:
  • Phone: 781-272-4944
  • Fax: 781-272-8756
Mailing address:
  • Phone: 781-272-4944
  • Fax: 781-272-8756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DAVID S GENDELMAN
Title or Position: PRESIDENT
Credential: MD
Phone: 781-272-4944