Provider Demographics
NPI:1336973882
Name:WHALEN OPHTHALMOLOGY LLC
Entity type:Organization
Organization Name:WHALEN OPHTHALMOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:WHALEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-739-4811
Mailing Address - Street 1:339 FLANDERS RD STE 109
Mailing Address - Street 2:
Mailing Address - City:EAST LYME
Mailing Address - State:CT
Mailing Address - Zip Code:06333-1731
Mailing Address - Country:US
Mailing Address - Phone:860-739-4811
Mailing Address - Fax:860-739-8151
Practice Address - Street 1:339 FLANDERS RD STE 109
Practice Address - Street 2:
Practice Address - City:EAST LYME
Practice Address - State:CT
Practice Address - Zip Code:06333-1731
Practice Address - Country:US
Practice Address - Phone:860-739-4811
Practice Address - Fax:860-739-8151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-28
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty