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General NPI Number Information
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NPI Number | 1528661600
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Entity Type | Organization
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Legal Business Name | OHPNTZ VISION LLC
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Dates
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Enumeration Date | 11/19/2020
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Last Update Date | 11/19/2020
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Provider Practice Location Address
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Address Line | 40 ENON ST
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City | BEVERLY
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State | MA
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Zip | 01915-1168
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Country | US
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Telephone | 781-922-7120
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Fax | 978-922-5997
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Provider Business Mailing Address
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Address Line | 5 PRINCETON ST
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City | PEABODY
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State | MA
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Zip | 01960-1408
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Country | US
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Telephone | 978-337-9655
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. STACY E BEAN
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Credential | OD
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Telephone | 978-337-9655
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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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