Provider Demographics
NPI:1194872119
Name:WESSON & NIRO EYECARE PC
Entity type:Organization
Organization Name:WESSON & NIRO EYECARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:A
Authorized Official - Last Name:WESSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:978-263-8521
Mailing Address - Street 1:296 GREAT RD
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-4710
Mailing Address - Country:US
Mailing Address - Phone:978-263-8521
Mailing Address - Fax:978-263-7319
Practice Address - Street 1:296 GREAT RD
Practice Address - Street 2:
Practice Address - City:ACTON
Practice Address - State:MA
Practice Address - Zip Code:01720-4710
Practice Address - Country:US
Practice Address - Phone:978-263-8521
Practice Address - Fax:978-263-7319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0031117OtherNEIGHBORHOOD HEALTH
MA712263OtherTUFTS
MA9733728Medicaid
MAW20125OtherHMO BLU
MA67880OtherFALLON
MA712263OtherTUFTS MEDICARE PREFERRED
MA0881450001Medicare NSC
MA9733728Medicaid