Basic Information
| Provider Information | |||||||||
| NPI: | 1255722906 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | POST, OCONNOR & KADRMAS EYE CENTERS DBA KADRMAS EYE CARE NEW ENGLAND | ||||||||
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| Mailing Information | |||||||||
| Address1: | 40 INDUSTRIAL PARK RD | ||||||||
| Address2: | |||||||||
| City: | PLYMOUTH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 023604884 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5087468600 | ||||||||
| FaxNumber: | 5087470824 | ||||||||
| Practice Location | |||||||||
| Address1: | 40 INDUSTRIAL PARK RD | ||||||||
| Address2: | |||||||||
| City: | PLYMOUTH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 023604884 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5087468600 | ||||||||
| FaxNumber: | 5087470824 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/16/2015 | ||||||||
| LastUpdateDate: | 02/16/2015 | ||||||||
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| AuthorizedOfficialLastName: | JUNJULAS | ||||||||
| AuthorizedOfficialFirstName: | NICHOLAS | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 5087468600 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Ophthalmology |
ID Information
| ID | Type | State | Issuer | Description | 110072299A | 05 | MA | MEDICAID | 608301 | 01 | TUFTS | OTHER | M16278 | 01 | MA | BC/BS | OTHER | CA2787 | 01 | RAILROAD MEDICARE | OTHER |