Healthcare Provider Details

I. General information

NPI: 1922020874
Provider Name (Legal Business Name): D'AMBROSIO EYE CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2006
Last Update Date: 04/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

479 OLD UNION TPKE
LANCASTER MA
01523-3029
US

IV. Provider business mailing address

479 OLD UNION TPKE
LANCASTER MA
01523-3029
US

V. Phone/Fax

Practice location:
  • Phone: 978-537-3900
  • Fax: 978-537-6030
Mailing address:
  • Phone: 978-537-3900
  • Fax: 978-537-6030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: FRANCIS A D'AMBROSIO JR.
Title or Position: OWNER
Credential: M.D.
Phone: 978-537-3900