Provider Demographics
NPI:1649462060
Name:NEW ENGLAND OPHTHALMOLOGY
Entity type:Organization
Organization Name:NEW ENGLAND OPHTHALMOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:B
Authorized Official - Last Name:CONSTANTINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-654-4000
Mailing Address - Street 1:500 CLARK RD
Mailing Address - Street 2:
Mailing Address - City:TEWKSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01876-1639
Mailing Address - Country:US
Mailing Address - Phone:978-654-4000
Mailing Address - Fax:978-654-4009
Practice Address - Street 1:500 CLARK RD
Practice Address - Street 2:
Practice Address - City:TEWKSBURY
Practice Address - State:MA
Practice Address - Zip Code:01876-1639
Practice Address - Country:US
Practice Address - Phone:978-654-4000
Practice Address - Fax:978-654-4009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty