Provider Demographics
NPI:1063781805
Name:PALUCH EYE CARE
Entity type:Organization
Organization Name:PALUCH EYE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:IRENA
Authorized Official - Middle Name:
Authorized Official - Last Name:PALUCH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:413-543-2933
Mailing Address - Street 1:PO BOX 51377
Mailing Address - Street 2:
Mailing Address - City:INDIAN ORCHARD
Mailing Address - State:MA
Mailing Address - Zip Code:01151-5377
Mailing Address - Country:US
Mailing Address - Phone:413-543-2933
Mailing Address - Fax:803-937-1798
Practice Address - Street 1:11 WILBRAHAM RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01199-3161
Practice Address - Country:US
Practice Address - Phone:413-543-2933
Practice Address - Fax:803-937-1798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-23
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA4163152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty