Provider Demographics
NPI:1285608067
Name:NORTHEAST EYE CARE, INC.
Entity type:Organization
Organization Name:NORTHEAST EYE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:LIGGIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-777-2292
Mailing Address - Street 1:80 LINDALL ST
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-2135
Mailing Address - Country:US
Mailing Address - Phone:978-777-2292
Mailing Address - Fax:978-777-7945
Practice Address - Street 1:503 BROADWAY
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:MA
Practice Address - Zip Code:02149-3603
Practice Address - Country:US
Practice Address - Phone:617-389-4800
Practice Address - Fax:617-387-4244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-16
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM20398Medicare ID - Type Unspecified
MA1007260002Medicare NSC