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General NPI Number Information
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NPI Number | 1609046580
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Entity Type | Organization
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Legal Business Name | MONOPLEX EYE PROSTHETICS
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Dates
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Enumeration Date | 03/06/2008
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Last Update Date | 06/01/2009
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Provider Practice Location Address
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Address Line | 54 MAIN ST
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City | STURBRIDGE
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State | MA
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Zip | 01566-1281
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Country | US
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Telephone | 508-347-3818
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Fax | 508-347-8285
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Provider Business Mailing Address
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Address Line | 169 S RIVER RD SUITE 14A
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City | BEDFORD
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State | NH
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Zip | 03110-6971
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Country | US
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Telephone | 603-622-5200
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Fax | 603-644-2354
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Authorized Official
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Title or Position | BOARD CERTIFIED OCULARIST
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Name | MR. PETER J KAZANOVICZ
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Credential | B.C.O.
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Telephone | 508-347-3818
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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