Healthcare Provider Details

I. General information

NPI: 1750355467
Provider Name (Legal Business Name): AMY CATHERINE NAU OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 08/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 COMMONWEALTH AVE STE 2
BOSTON MA
02215-2813
US

IV. Provider business mailing address

400 COMMONWEALTH AVE STE 2
BOSTON MA
02215-2813
US

V. Phone/Fax

Practice location:
  • Phone: 617-426-0370
  • Fax:
Mailing address:
  • Phone: 617-426-0370
  • Fax: 617-426-5119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4212
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number4212
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: