Healthcare Provider Details

I. General information

NPI: 1386791663
Provider Name (Legal Business Name): LAURA OKALANI MILNER O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 ELECTRIC AVE
FITCHBURG MA
01420-7954
US

IV. Provider business mailing address

21 ELLIOTT RD
STERLING MA
01564-2005
US

V. Phone/Fax

Practice location:
  • Phone: 978-342-8752
  • Fax: 978-342-1970
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4000
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: