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General NPI Number Information
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NPI Number | 1043410244
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Entity Type | Organization
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Legal Business Name | MASS OPTOMETRIC ASSOCIATES, PLLC
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Dates
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Enumeration Date | 07/25/2007
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 1623 BEACON ST WASHINGTON SQUARE
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City | BROOKLINE
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State | MA
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Zip | 02445-4531
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Country | US
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Telephone | 617-739-2707
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Fax | 617-730-4418
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Provider Business Mailing Address
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Address Line | 175 E HOUSTON ST
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City | SAN ANTONIO
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State | TX
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Zip | 78205-2299
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Country | US
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Telephone | 800-340-0219
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Fax | 210-524-6587
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Authorized Official
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Title or Position | OD/PRESIDENT
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Name | RANDI FRANKL
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Credential |
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Telephone | 516-815-1646
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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