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General NPI Number Information
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NPI Number | 1124480520
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Entity Type | Individual
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Provider Name | JEFFREY HO O.D.
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Gender | Male
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Dates
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Enumeration Date | 03/24/2016
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Last Update Date | 08/15/2023
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Provider Practice Location Address
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Address Line | 15 TUFTS ST
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City | CHARLESTOWN
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State | MA
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Zip | 02129-2711
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Country | US
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Telephone | 857-238-1161
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Fax | 857-238-1167
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Provider Business Mailing Address
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Address Line | 1091 BOYLSTON ST APT 23
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City | BOSTON
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State | MA
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Zip | 02215-3656
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Country | US
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Telephone | 626-679-5499
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Fax | 857-238-1167
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG003135
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 5148
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License Number State | MA
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