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General NPI Number Information
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NPI Number | 1467577759
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Entity Type | Organization
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Legal Business Name | SALEM EYE ASSOCIATES
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 197 LAFAYETTE ST
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City | SALEM
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State | MA
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Zip | 01970-4739
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Country | US
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Telephone | 978-744-2675
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Fax | 978-744-8982
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Provider Business Mailing Address
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Address Line | 197 LAFAYETTE ST
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City | SALEM
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State | MA
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Zip | 01970-4739
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Country | US
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Telephone | 978-744-2675
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Fax | 978-744-8982
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRIAN T MCHUGH
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Credential | OD
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Telephone | 978-744-2675
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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 | 3114
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License Number State | MA
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