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General NPI Number Information
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NPI Number | 1659010056
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Entity Type | Organization
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Legal Business Name | GAO EYE ASSOCIATES LLC
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Dates
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Enumeration Date | 06/02/2022
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Last Update Date | 06/02/2022
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Provider Practice Location Address
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Address Line | 339 SQUIRE RD
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City | REVERE
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State | MA
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Zip | 02151-4309
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Country | US
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Telephone | 781-289-5900
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Fax |
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Provider Business Mailing Address
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Address Line | 212 MERRIMACK MEADOWS LN
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City | TEWKSBURY
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State | MA
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Zip | 01876-1083
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Country | US
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Telephone | 203-285-5639
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | ZHENZHEN GAO
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Credential | OD
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Telephone | 203-285-5639
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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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