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Physician Compare National (NPI:1104960384)

HEALTHCARE PROVIDER: THOMAS EDWARD NOONAN OD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1104960384
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 0345370870
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20100927001256
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name NOONAN
Individual professional last name
Provider First Name THOMAS
Individual professional first name
Provider Middle Name EDWARD
Individual professional middle name
Provider Gender M
The provider's gender if the provider is a person.

Medical School Information

Medical School Name NEW ENGLAND COLLEGE OF OPTOMETRY
Individual professional's medical school
Graduation Year 1983
Individual professional's medical school graduation year
Primary Specialty OPTOMETRY
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Organization Legal Name STRATFORD EYECARE ASSOCIATES LLC
Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID 3375673809
Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members 2
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 3333 MAIN ST
Group Practice or individual's line 1 address
Line 2 Street Address FL 1
Group Practice or individual's line 2 address
City STRATFORD
Group Practice or individual's city
State CT
Group Practice or individual's state
Zip Code 066144861
Group Practice or individual's zip code (9 digits when available)
Phone Number 2033782269
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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