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General NPI Number Information
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NPI Number | 1265097935
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Entity Type | Organization
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Legal Business Name | EDWARD EYE ASSOCIATES LLC
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Dates
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Enumeration Date | 05/07/2019
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Last Update Date | 07/31/2024
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Provider Practice Location Address
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Address Line | 550 ARSENAL ST
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City | WATERTOWN
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State | MA
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Zip | 02472-2853
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Country | US
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Telephone | 617-923-6054
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Fax | 857-400-0712
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Provider Business Mailing Address
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Address Line | 550 ARSENAL ST
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City | WATERTOWN
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State | MA
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Zip | 02472-2853
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Country | US
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Telephone | 617-934-9314
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Fax | 857-400-0712
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | HANNAH EDWARD
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Credential | OD
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Telephone | 617-934-9314
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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 |
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