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General NPI Number Information
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NPI Number | 1336385087
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Entity Type | Organization
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Legal Business Name | MERRIMACK EYE CARE, LLC
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Dates
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Enumeration Date | 12/31/2008
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Last Update Date | 02/27/2009
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Provider Practice Location Address
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Address Line | 50 FOX RUN RD SUITE 62
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City | NEWINGTON
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State | NH
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Zip | 03801-2851
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Country | US
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Telephone | 603-427-0022
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Fax | 603-430-2053
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Provider Business Mailing Address
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Address Line | 50 FOX RUN RD SUITE 62
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City | NEWINGTON
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State | NH
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Zip | 03801-2851
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Country | US
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Telephone | 603-427-0022
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Fax | 603-430-2053
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Authorized Official
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Title or Position | MANAGER
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Name | DR. SURAJ SADEGHI AFSHAR
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Credential | O.D.
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Telephone | 603-427-0022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4714
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0821
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License Number State | NH
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