Provider Demographics
NPI:1215119169
Name:SPECIALTY EYE GROUP PC
Entity type:Organization
Organization Name:SPECIALTY EYE GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:TANNOUS
Authorized Official - Last Name:FRANGIEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACS
Authorized Official - Phone:781-910-6210
Mailing Address - Street 1:32 DAY ST
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062
Mailing Address - Country:US
Mailing Address - Phone:781-610-6210
Mailing Address - Fax:781-769-2850
Practice Address - Street 1:32 DAY ST
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062
Practice Address - Country:US
Practice Address - Phone:781-610-6210
Practice Address - Fax:781-769-2850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA58094174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty