Healthcare Provider Details

I. General information

NPI: 1235355199
Provider Name (Legal Business Name): EMILY H PILOTTE O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 COMMONWEALTH AVE
BOSTON MA
02215-1274
US

IV. Provider business mailing address

129 HILLSIDE RD UNIT 2
WATERTOWN MA
02472-1475
US

V. Phone/Fax

Practice location:
  • Phone: 617-262-2020
  • Fax:
Mailing address:
  • Phone: 617-872-4242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4440
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: