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NPI Code Detail

MEDICARE: ERIN CIVETTI OD

MEDICARE: ERIN CIVETTI OD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist5414MA

General Provider Information

NPI Number : 1174131882
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIN CIVETTI OD
Provider Business Mailing Address
First Line : 7 BEAR HILL RD
Second Line :
City : MILFORD
State : MA
Zip : 01757-3619
Country : US
Telephone Number : 508-577-3367
Fax Number :
Provider Business Practice Location Address
First Line : 41 ANDREW AVE
Second Line :
City : WAYLAND
State : MA
Zip : 01778-3026
Country : US
Telephone Number : 508-426-5092
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2020
Last Update Date : 02/21/2025

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