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General NPI Number Information
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NPI Number | 1053684027
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Entity Type | Organization
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Legal Business Name | SANDRA M. PAYTON VISION CARE, INC
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Dates
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Enumeration Date | 02/21/2012
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Last Update Date | 10/06/2016
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Provider Practice Location Address
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Address Line | 1147 HANCOCK ST STE E
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City | QUINCY
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State | MA
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Zip | 02169-4330
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Country | US
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Telephone | 857-300-3039
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 749
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City | RANDOLPH
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State | MA
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Zip | 02368-0749
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. SANDRA PAYTON
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Credential |
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Telephone | 857-300-3039
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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 | 4696
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License Number State | MA
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