Organization
ADVANCED EYECARE SPECIALISTS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY JON SAJBAN O.D. (PRESIDENT)
(508) 280-2479
Entity
Organization
Contact information
Practice address
352 MAIN ST, FALMOUTH, MA 02540-3175
(508) 444-8691
(508) 444-8693
Mailing address
619 WAKEBY RD, MARSTONS MILLS, MA 02648-1623
(508) 280-2479
(508) 428-1118
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3456
MA
152WC0802X
Corneal and Contact Management Optometrist
3456
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0011817
MEDICARE (PTAN)
MA
05
—
0371751
—
MA
01
—
1942244835
NPI- INDIVIDUAL NUMBER
—
01
—
423858
MEDICARE ID-TYPE UNSPECIFIED
MA
Enumeration date
06/21/2009
Last updated
11/02/2009
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