# EYE CENTER NORTHEAST

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174603872
- **Authorized official:** MR. REGINALD R ARNOLD JR. (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (207) 947-1291

## Contact information

- **Practice address:** 417 STATE ST, SUITE 230, BANGOR, ME 04401-6620
- **Practice address phone:** (207) 947-1291
- **Practice address fax:** (207) 947-9241
- **Mailing address:** 417 STATE ST, SUITE 230, BANGOR, ME 04401-6620
- **Mailing address phone:** (207) 947-1291
- **Mailing address fax:** (207) 947-9241

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/17/2006
- **Last updated:** 06/02/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1042060 | AETNA | — |
| 05 | — | 114630000 | — | ME |
| 05 | — | 114630100 | — | ME |