Organization Name: | SWAMSCOTT OPTICAL, INC. |
NPI Number: | 1154456697 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOHN E. CAVICCHI (OPTICIAN) |
Mailing Address: | 990 Paradise Rd Swampscott |
State: | MA US |
Postal Code: | 019071395 |
Phone Number: | 7815951222 |
Fax Number: | |
NPI Enumeration Date: | 02/23/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | 1820 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |