Healthcare Provider Details

I. General information

NPI: 1215119169
Provider Name (Legal Business Name): SPECIALTY EYE GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2007
Last Update Date: 12/03/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 DAY ST
NORWOOD MA
02062
US

IV. Provider business mailing address

32 DAY ST
NORWOOD MA
02062
US

V. Phone/Fax

Practice location:
  • Phone: 781-610-6210
  • Fax: 781-769-2850
Mailing address:
  • Phone: 781-610-6210
  • Fax: 781-769-2850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number58094
License Number StateMA

VIII. Authorized Official

Name: DR. GEORGE TANNOUS FRANGIEH
Title or Position: DOCTOR/OWNER
Credential: MD, FACS
Phone: 781-910-6210