Healthcare Provider Details

I. General information

NPI: 1245720655
Provider Name (Legal Business Name): PAUL TIERI OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2018
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 FRANKLIN VILLAGE DR
FRANKLIN MA
02038-4005
US

IV. Provider business mailing address

230 FRANKLIN VILLAGE DR
FRANKLIN MA
02038-4005
US

V. Phone/Fax

Practice location:
  • Phone: 508-528-3911
  • Fax:
Mailing address:
  • Phone: 508-528-3911
  • Fax: 508-553-0824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number5284
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1069
License Number StateNH
# 3
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number011135
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: