Provider Demographics
NPI:1063605251
Name:CLEAR VISION EYE CENTER,INC
Entity type:Organization
Organization Name:CLEAR VISION EYE CENTER,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NILESH
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHETH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-979-0960
Mailing Address - Street 1:3 WOODLAND RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-1702
Mailing Address - Country:US
Mailing Address - Phone:781-979-0960
Mailing Address - Fax:781-979-0618
Practice Address - Street 1:3 WOODLAND RD
Practice Address - Street 2:SUITE 120
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-1702
Practice Address - Country:US
Practice Address - Phone:781-979-0960
Practice Address - Fax:781-979-0618
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HORSLEY EYE CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-22
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA218562207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0003012Medicare PIN
MAH96247Medicare UPIN