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General NPI Number Information
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NPI Number | 1104687706
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Entity Type | Individual
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Provider Name | O'NEIL CHRISTOPHER WRIGHT LDO, ABOC, NCLEC
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Gender | Male
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Dates
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Enumeration Date | 01/22/2024
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Last Update Date | 01/22/2024
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Provider Practice Location Address
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Address Line | 24 SONOMA ST
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City | DORCHESTER
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State | MA
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Zip | 02121-2934
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Country | US
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Telephone | 617-352-9588
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Fax |
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Provider Business Mailing Address
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Address Line | 24 SONOMA ST APT 4
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City | DORCHESTER
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State | MA
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Zip | 02121-2934
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Country | US
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Telephone | 857-209-6010
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | DOP6845
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License Number State | MA
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