Provider Demographics
NPI:1528287810
Name:HAMPDEN EYE PHYSICIANS AND SURGEONS, P.C.
Entity type:Organization
Organization Name:HAMPDEN EYE PHYSICIANS AND SURGEONS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BATLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:413-535-1700
Mailing Address - Street 1:470 GRANBY RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SOUTH HADLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01075-3218
Mailing Address - Country:US
Mailing Address - Phone:413-535-1700
Mailing Address - Fax:413-535-1715
Practice Address - Street 1:470 GRANBY RD
Practice Address - Street 2:SUITE 103
Practice Address - City:SOUTH HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01075-3218
Practice Address - Country:US
Practice Address - Phone:413-535-1700
Practice Address - Fax:413-535-1715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA219578207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2025361Medicaid
MAAA90150OtherHPHP
MAG24693Medicare UPIN
MA2025361Medicaid