Healthcare Provider Details
I. General information
NPI: 1053378265
Provider Name (Legal Business Name): NEW ENGLAND EYE SURGICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/01/2006
Last Update Date: 05/16/2023
Certification Date: 05/16/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
696 MAIN ST
WEYMOUTH MA
02190
US
IV. Provider business mailing address
696 MAIN ST
WEYMOUTH MA
02190
US
V. Phone/Fax
- Phone: 781-331-3820
- Fax: 781-331-1076
- Phone: 781-331-3820
- Fax: 781-331-1076
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QS0132X |
| Taxonomy | Ophthalmologic Surgery Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
KENNETH
J
CAMEROTA
Title or Position: ADMINISTRATOR
Credential:
Phone: 781-331-3820