1851966162 NPI number — OPHTHALMIC CONSULTANTS OF BOSTON, INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851966162 NPI number — OPHTHALMIC CONSULTANTS OF BOSTON, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OPHTHALMIC CONSULTANTS OF BOSTON, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851966162
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/22/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
50 STANIFORD ST STE 600
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BOSTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02114-2587
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-635-0489
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
97 LIBBEY INDUSTRIAL PKWY STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST WEYMOUTH
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02189-3110
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-331-3300
Provider Business Practice Location Address Fax Number:
781-337-8356
Provider Enumeration Date:
05/20/2021

Additional Information

Authorized Official

Authorized Official Last Name:
HAMILTON
Authorized Official First Name:
HELEN
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF ACCOUNTS PAYABLE
Authorized Official Telephone Number:
508-534-6003

Provider Taxonomy Codes

  • Taxonomy code: 332H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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