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General NPI Number Information
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NPI Number | 1477624542
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Entity Type | Individual
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Provider Name | JOHN JOSEPH IANNITTO O.D.
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Gender | Male
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Dates
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Enumeration Date | 11/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 180 ENDICOTT ST
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City | DANVERS
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State | MA
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Zip | 01923-3683
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Country | US
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Telephone | 978-774-4500
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Fax | 978-774-0974
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Provider Business Mailing Address
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Address Line | 27 HEARD DR
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City | IPSWICH
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State | MA
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Zip | 01938-1628
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Country | US
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Telephone | 978-621-9828
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 3131
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License Number State | MA
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