Basic Information
| Provider Information | |||||||||
| NPI: | 1831289263 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EYECARE PLUS LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 228 S MAIN ST | ||||||||
| Address2: | EYECARE PLUS LLC | ||||||||
| City: | NEWTOWN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 064702764 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2034263545 | ||||||||
| FaxNumber: | 2033641866 | ||||||||
| Practice Location | |||||||||
| Address1: | 228 S MAIN ST | ||||||||
| Address2: | EYECARE PLUS LLC | ||||||||
| City: | NEWTOWN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 064702764 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2034263545 | ||||||||
| FaxNumber: | 2033641866 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/14/2006 | ||||||||
| LastUpdateDate: | 05/30/2008 | ||||||||
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| AuthorizedOfficialLastName: | HARVEY | ||||||||
| AuthorizedOfficialFirstName: | DEAN | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2034263545 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | OD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | CT2094 | CT | Y | 193400000X SINGLE SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist |
No ID Information.