Provider Demographics
NPI:1942010665
Name:MIDDLESEX EYE PHYSICIANS P.C.
Entity type:Organization
Organization Name:MIDDLESEX EYE PHYSICIANS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPHTHALMOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KRISTY
Authorized Official - Middle Name:G
Authorized Official - Last Name:MASCARENHAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-347-7466
Mailing Address - Street 1:400 SAYBROOK RD STE 100
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-4774
Mailing Address - Country:US
Mailing Address - Phone:860-347-7466
Mailing Address - Fax:
Practice Address - Street 1:610 FOXON RD
Practice Address - Street 2:
Practice Address - City:EAST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06513-1967
Practice Address - Country:US
Practice Address - Phone:203-468-8800
Practice Address - Fax:203-458-9456
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MIDDLESEX EYE PHYSICIANS, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty