Healthcare Provider Details

I. General information

NPI: 1114179223
Provider Name (Legal Business Name): SIKALIS EYE ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2008
Last Update Date: 10/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 CHELMSFORD ST
LOWELL MA
01851-5149
US

IV. Provider business mailing address

850 CHELMSFORD ST
LOWELL MA
01851-5149
US

V. Phone/Fax

Practice location:
  • Phone: 978-452-0127
  • Fax:
Mailing address:
  • Phone: 978-452-0127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3120
License Number StateMA

VIII. Authorized Official

Name: DR. STEVEN SIKALIS
Title or Position: OPTOMETRIST/OWNER
Credential: O.D.
Phone: 978-452-0127