Healthcare Provider Details

I. General information

NPI: 1174175855
Provider Name (Legal Business Name): SABRINA GAAN OD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2019
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 MAN MAR DR UNIT 2
PLAINVILLE MA
02762-2272
US

IV. Provider business mailing address

51 MAN MAR DR UNIT 2
PLAINVILLE MA
02762-2272
US

V. Phone/Fax

Practice location:
  • Phone: 508-222-9912
  • Fax: 508-222-9914
Mailing address:
  • Phone: 508-222-9912
  • Fax: 508-222-9914

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: ERIN SMITH
Title or Position: BILLING MANAGER
Credential:
Phone: 508-222-9912