Healthcare Provider Details

I. General information

NPI: 1427034263
Provider Name (Legal Business Name): STEVEN SIKALIS O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/22/2005
Last Update Date: 07/08/2007
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: 978-452-1749
Mailing address:
  • Phone: 978-452-0127
  • Fax: 978-452-1749

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: