Provider Demographics
NPI:1962775783
Name:EYE ASSOCIATES OF MILFORD, P.C.
Entity type:Organization
Organization Name:EYE ASSOCIATES OF MILFORD, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BROTHERS
Authorized Official - Suffix:I
Authorized Official - Credentials:MD
Authorized Official - Phone:203-878-0666
Mailing Address - Street 1:255 W RIVER ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06461-2628
Mailing Address - Country:US
Mailing Address - Phone:203-878-0666
Mailing Address - Fax:203-878-9938
Practice Address - Street 1:255 W RIVER ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06461-2628
Practice Address - Country:US
Practice Address - Phone:203-878-0666
Practice Address - Fax:203-878-9938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-10
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT015509305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization