Healthcare Provider Details

I. General information

NPI: 1033379219
Provider Name (Legal Business Name): CHILDRENS HOSPITAL OPHTHALMOLOGY FOUNDATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2008
Last Update Date: 06/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

OPHTHALMOLOGY SUITE 9 HOPE AVE CHILDRENS HOSPITAL BOSTON AT WALTHAM
WALTHAM MA
02456-2741
US

IV. Provider business mailing address

OPHTHALMOLOGY SUITE 9 HOPE AVE CHILDRENS HOSPITAL BOSTON AT WALTHAM
WALTHAM MA
02453-2741
US

V. Phone/Fax

Practice location:
  • Phone: 781-216-1420
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID HUNTER
Title or Position: CHIEF
Credential:
Phone: 617-355-6401