Basic Information
| Provider Information | |||||||||
| NPI: | 1427240134 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VILLAGE EYE CARE, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7 HADLEY ST | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | SOUTH HADLEY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010751058 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135366100 | ||||||||
| FaxNumber: | 4135368100 | ||||||||
| Practice Location | |||||||||
| Address1: | 7 HADLEY ST | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | SOUTH HADLEY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010751058 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135366100 | ||||||||
| FaxNumber: | 4135368100 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/16/2007 | ||||||||
| LastUpdateDate: | 03/13/2008 | ||||||||
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| AuthorizedOfficialLastName: | MARKOW | ||||||||
| AuthorizedOfficialFirstName: | STEVEN | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 4135366100 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist |
No ID Information.