Optometric Providers INC
Optometrist in Boston, MA. Organization (NPI-2).
NPI number1790734010
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1790734010
- Entity type
- Organization (NPI-2)
- Legal business name
- Optometric Providers INC
- Organization subpart
- No
- Enumeration date
- May 6, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | – | – | Yes |
Practice location
100 State StBoston, MA 02109
Phone 617-742-2076 · Fax 617-557-9276
Mailing address
2921 Erie Blvd EOptometric Providers INC
Syracuse, NY 13224
Phone 315-446-3145 · Fax 315-445-7675
Authorized official
Alerino M Iacobbo
President
3144463145
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