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General NPI Number Information
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NPI Number | 1548480403
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Entity Type | Organization
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Legal Business Name | NEURO-OPHTHALMOLOGY & EYECARE P.C.
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 07/04/2019
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Provider Practice Location Address
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Address Line | 2036A BOSTON RD
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City | WILBRAHAM
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State | MA
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Zip | 01095
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Country | US
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Telephone | 413-543-5444
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Fax |
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Provider Business Mailing Address
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Address Line | 2036A BOSTON RD
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City | WILBRAHAM
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State | MA
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Zip | 01095-1102
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Country | US
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Telephone | 413-543-5444
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Fax |
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Authorized Official
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Title or Position | PROVIDER PHYSICIAN
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Name | DR. ERKAN MUTLUKAN
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Credential |
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Telephone | 413-543-5444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 161328
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | 161328
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 161328
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License Number State | MA
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