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General NPI Number Information
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NPI Number | 1295958486
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Entity Type | Organization
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Legal Business Name | KATHLEEN M. CLEARY , OD. PC
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 07/06/2010
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Provider Practice Location Address
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Address Line | 470 SOUTHERN ARTERY
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City | QUINCY
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State | MA
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Zip | 02169-4614
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Country | US
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Telephone | 617-773-8050
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Fax | 617-770-9453
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Provider Business Mailing Address
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Address Line | 470 SOUTHERN ARTERY
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City | QUINCY
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State | MA
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Zip | 02169-4614
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Country | US
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Telephone | 617-773-8050
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Fax | 617-770-9453
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Authorized Official
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Title or Position | DOCTOR OF OPTOMETRY
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Name | KATHLEEN MONICA CLEARY
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Credential | O.D.
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Telephone | 617-773-8050
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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 | 3420
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License Number State | MA
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