Healthcare Provider Details

I. General information

NPI: 1235135781
Provider Name (Legal Business Name): DAVID J SCHURGIN O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2005
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 PARK ST APT C5
STONEHAM MA
02180-2758
US

IV. Provider business mailing address

224 PARK ST APT C5
STONEHAM MA
02180-2758
US

V. Phone/Fax

Practice location:
  • Phone: 781-438-8407
  • Fax:
Mailing address:
  • Phone: 781-438-8407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2345T
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number2345T
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: