Healthcare Provider Details

I. General information

NPI: 1427248673
Provider Name (Legal Business Name): MASS OPTOMETRIC ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2007
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139 ENDICOTT ST ENDICOTT PLAZA
DANVERS MA
01923-4803
US

IV. Provider business mailing address

175 E HOUSTON ST
SAN ANTONIO TX
78205-2299
US

V. Phone/Fax

Practice location:
  • Phone: 978-777-4700
  • Fax: 978-750-0862
Mailing address:
  • Phone: 3-400-1298
  • Fax: 210-524-6587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

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