Healthcare Provider Details

I. General information

NPI: 1659497782
Provider Name (Legal Business Name): LORRAINE LABIENTO SMITH OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 04/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

344 BOSTON POST ROAD SUDBURY EYE CARE
SUDBURY MA
01776
US

IV. Provider business mailing address

344 BOSTON POST RD
SUDBURY MA
01776-3007
US

V. Phone/Fax

Practice location:
  • Phone: 978-443-3021
  • Fax: 978-610-2620
Mailing address:
  • Phone: 978-443-3021
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4334
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number4334
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: