Healthcare Provider Details
I. General information
NPI: 1871777565
Provider Name (Legal Business Name): EYE CARE SPECIALISTS PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/18/2007
Last Update Date: 10/21/2024
Certification Date: 10/21/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
825 WASHINGTON ST GUILD MEDICAL BUILDING, SUITE 230
NORWOOD MA
02062-3441
US
IV. Provider business mailing address
825 WASHINGTON ST GUILD MEDICAL BUILDING, SUITE 230
NORWOOD MA
02062-3441
US
V. Phone/Fax
- Phone: 781-769-8880
- Fax: 781-769-2850
- Phone: 781-769-8880
- Fax: 781-769-2850
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207WX0107X |
| Taxonomy | Retina Specialist (Ophthalmology) Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 152WC0802X |
| Taxonomy | Corneal and Contact Management Optometrist |
| License Number | 58094 |
| License Number State | MA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207WX0009X |
| Taxonomy | Glaucoma Specialist (Ophthalmology) Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
GEORGE
TANNOUS
FRANGIEH
Title or Position: OWNER/DOCTOR
Credential: MD,FACS
Phone: 781-910-6210