Healthcare Provider Details

I. General information

NPI: 1023077757
Provider Name (Legal Business Name): THE BOSTON FOUNDATION FOR SIGHT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 02/13/2020
Certification Date: 02/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

464 HILLSIDE AVE SUITE 205
NEEDHAM MA
02494-1227
US

IV. Provider business mailing address

464 HILLSIDE AVE SUITE 205
NEEDHAM MA
02494-1227
US

V. Phone/Fax

Practice location:
  • Phone: 781-726-7337
  • Fax: 781-726-7310
Mailing address:
  • Phone: 781-726-7337
  • Fax: 781-726-7310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number4412
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number27372
License Number StateMA

VIII. Authorized Official

Name: LYNN CARTER
Title or Position: BILLING MANGER
Credential:
Phone: 781-726-7337