Healthcare Provider Details

I. General information

NPI: 1568495349
Provider Name (Legal Business Name): NORTHEAST EYE CARE ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 03/04/2020
Certification Date: 03/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 NORTH RD
DEERFIELD NH
03037-1400
US

IV. Provider business mailing address

PO BOX 428
DEERFIELD NH
03037-0428
US

V. Phone/Fax

Practice location:
  • Phone: 603-463-7373
  • Fax: 603-463-7390
Mailing address:
  • Phone: 603-463-7373
  • Fax: 603-463-7390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. SUSAN FISCHER
Title or Position: PRESIDENT
Credential:
Phone: 603-964-9340