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General NPI Number Information
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NPI Number | 1235312729
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Entity Type | Organization
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Legal Business Name | CAROLANN SPERANZO
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Dates
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Enumeration Date | 12/07/2007
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Last Update Date | 06/16/2008
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Provider Practice Location Address
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Address Line | 1147 HANCOCK ST
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City | QUINCY
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State | MA
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Zip | 02169-4343
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Country | US
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Telephone | 617-773-1178
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Fax |
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Provider Business Mailing Address
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Address Line | 1147 HANCOCK ST
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City | QUINCY
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State | MA
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Zip | 02169-4343
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Country | US
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Telephone | 617-773-1178
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. CAROLANN MARIE SPERANZO
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Credential | RDO
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Telephone | 617-773-1178
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 1701
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 1701
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License Number State | MA
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