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General NPI Number Information
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NPI Number | 1336488014
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Entity Type | Organization
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Legal Business Name | 1 ON 1 EYECARE
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Dates
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Enumeration Date | 01/31/2013
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Last Update Date | 07/30/2019
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Provider Practice Location Address
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Address Line | 66 SEYON STREET
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City | WALTHAM
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State | MA
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Zip | 02453
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Country | US
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Telephone | 781-891-0136
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Fax |
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Provider Business Mailing Address
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Address Line | 24 MONTVALE ST
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City | ROSLINDALE
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State | MA
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Zip | 02131-2752
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Country | US
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Telephone | 781-891-0136
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ARTHUR BABABEKOV
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Credential | OD
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Telephone | 781-891-0136
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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 | 4436
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License Number State | MA
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