Healthcare Provider Details

I. General information

NPI: 1609076827
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: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 FRANKLIN VILLAGE DR FRANKLIN VILLAGE PLAZA
FRANKLIN MA
02038-4005
US

IV. Provider business mailing address

2921 ERIE BLVD E C/O EMPIRE VISION CENTER, INC
SYRACUSE NY
13224-1430
US

V. Phone/Fax

Practice location:
  • Phone: 508-528-3911
  • Fax: 508-528-0824
Mailing address:
  • Phone: 315-446-3145
  • Fax: 315-445-7675

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