Organization Name: | C E OPTICAL |
NPI Number: | 1124207816 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GENE MACDONALD (OPTICIAN) |
Mailing Address: | 820 Washington St Braintree |
State: | MA US |
Postal Code: | 021846421 |
Phone Number: | 7818430121 |
Fax Number: | |
NPI Enumeration Date: | 10/30/2007 |
NPI Last Update Date: | 10/30/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | 2023 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |