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General NPI Number Information
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NPI Number | 1124160973
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Entity Type | Organization
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Legal Business Name | EYE CARE FOR KIDS, LLC
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 95 WASHINGTON ST SUITE 592
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City | CANTON
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State | MA
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Zip | 02021-4006
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Country | US
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Telephone | 781-769-4797
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Fax | 781-769-4794
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Provider Business Mailing Address
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Address Line | 1 TAMARACK WAY
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City | SHARON
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State | MA
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Zip | 02067-2343
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Country | US
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Telephone | 781-769-4797
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Fax | 781-769-4794
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Authorized Official
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Title or Position | OWNER
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Name | DR. DANIEL M LABY
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Credential | MD
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Telephone | 781-769-4797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 159550
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License Number State | MA
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