Northeastern Eye Center Inc

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

35055038 Issued in OH

Legal business name

NORTHEASTERN EYE CENTER INC

Practice address

29111 Center Ridge Rd
Westlake, OH 44145-5222

Phone

(440) 777-2667

NPI assigned

Aug 20, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Betty Rozakis

Title

Cfo

Phone

(440) 777-2667

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1219190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318377600000",
    "number": "1295982312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "892 BEACH RD",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441071018",
            "telephone_number": "440-777-2667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29111 CENTER RIDGE RD",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441455222",
            "telephone_number": "440-777-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEASTERN EYE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-20",
        "last_updated": "2011-10-12",
        "status": "A",
        "authorized_official_last_name": "ROZAKIS",
        "authorized_official_first_name": "BETTY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "440-777-2667"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "35055038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0655189",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Westlake, OH
• Providers in Westlake, OH by specialty
• Ophthalmology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.