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General NPI Number Information
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NPI Number | 1124228358
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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 | 11/05/2024
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Provider Practice Location Address
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Address Line | 200 WESTGATE DR SPACE E133
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City | BROCKTON
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State | MA
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Zip | 02301-1885
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Country | US
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Telephone | 508-587-9700
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Fax | 508-587-0646
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Provider Business Mailing Address
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Address Line | 2921 ERIE BLVD E C/O EMPIRE VISION CENTER, INC
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City | SYRACUSE
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State | NY
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Zip | 13224-1430
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Country | US
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Telephone | 315-446-3145
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Fax | 315-445-7675
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Authorized Official
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Title or Position | PRESIDENT
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Name | RANDI FRANKL
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Credential | OD
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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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