Provider Demographics
NPI:1174777122
Name:THE EYE CARE CENTER, INC.
Entity type:Organization
Organization Name:THE EYE CARE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BOGOSIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-568-8228
Mailing Address - Street 1:10 TECHNOLOGY DR
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:MA
Mailing Address - Zip Code:01749-2791
Mailing Address - Country:US
Mailing Address - Phone:978-568-8228
Mailing Address - Fax:978-568-0330
Practice Address - Street 1:10 TECHNOLOGY DR
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:MA
Practice Address - Zip Code:01749-2791
Practice Address - Country:US
Practice Address - Phone:978-568-8228
Practice Address - Fax:978-568-0330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-04
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000877601Medicare PIN
MAW1750901Medicare PIN