Doctor Name: | MR. LEONARD C. SHWOM |
NPI Number: | 1740432889 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | RDO |
License Number: | 1372 |
Business Practice Address: | 584 High St Dedham, MA - 020261807 |
Business Phone Number: | 7814714337 |
Business Fax Number: | 7814714339 |
Mailing Address: | 584 High St, DEDHAM |
State: | MA |
Postal Code: | 020261807 |
Phone Number: | 7814714337 |
Fax Number: | 7814714339 |
NPI Enumeration Date: | 10/21/2008 |
NPI Last Update Date: | 03/16/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332H00000X |
License Number: | 1372 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Eyewear Supplier (Equipment, not the service) |
Taxonomy Specialization: | |
Taxonomy Definition: | An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |