Healthcare Provider Details
I. General information
NPI: 1386615193
Provider Name (Legal Business Name): MEDICAL EYE CARE ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/30/2006
Last Update Date: 07/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
95 CHAPEL ST
NORWOOD MA
02062-3155
US
IV. Provider business mailing address
95 CHAPEL ST
NORWOOD MA
02062-3155
US
V. Phone/Fax
- Phone: 781-762-9018
- Fax: 781-762-0118
- Phone: 781-762-9018
- Fax: 781-762-0118
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
GEORGE
A
VIOLIN
Title or Position: PRESIDENT/OWNER
Credential: M.D.
Phone: 781-255-8336