Healthcare Provider Details

I. General information

NPI: 1134357379
Provider Name (Legal Business Name): NEWTON OPTICA, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2009
Last Update Date: 06/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1191 CHESTNUT ST
NEWTON MA
02464-1351
US

IV. Provider business mailing address

1191 CHESTNUT ST
NEWTON MA
02464-1351
US

V. Phone/Fax

Practice location:
  • Phone: 617-243-3937
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number4718
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4718
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. VIKTORIYA VILKOMIR
Title or Position: PRESIDENT
Credential: OD
Phone: 617-243-3937