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General NPI Number Information
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NPI Number | 1154793958
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Entity Type | Organization
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Legal Business Name | UNIVERSITY EYE CARE, LLC
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Dates
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Enumeration Date | 10/20/2015
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Last Update Date | 03/18/2016
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Provider Practice Location Address
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Address Line | 221 UNIVERSITY AVE
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City | WESTWOOD
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State | MA
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Zip | 02090-2333
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Country | US
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Telephone | 781-326-7359
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 152
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City | NORWOOD
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State | MA
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Zip | 02062-0152
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Country | US
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Telephone | 781-326-7359
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | CONSTANCE LEE
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Credential | O.D.
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Telephone | 781-326-7359
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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 | 4100
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License Number State | MA
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