Healthcare Provider Details

I. General information

NPI: 1972059723
Provider Name (Legal Business Name): MASS OPTOMETRIC ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2016
Last Update Date: 09/20/2024
Certification Date: 09/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

228 WASHINGTON ST STE A100
ATTLEBORO MA
02703-5518
US

IV. Provider business mailing address

PO BOX 417821
BOSTON MA
02241-7821
US

V. Phone/Fax

Practice location:
  • Phone: 210-524-6922
  • Fax: 210-524-6587
Mailing address:
  • Phone: 800-349-5120
  • Fax: 210-524-6587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: RANDI FRANKL
Title or Position: PRESIDENT
Credential:
Phone: 516-815-1646