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General NPI Number Information
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NPI Number | 1770266827
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Entity Type | Organization
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Legal Business Name | ENO ONE OPTICAL
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Dates
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Enumeration Date | 08/07/2023
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Last Update Date | 05/09/2024
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Provider Practice Location Address
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Address Line | 18 HURON DR
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City | NATICK
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State | MA
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Zip | 01760-5076
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Country | US
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Telephone | --
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2104
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City | NATICK
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State | MA
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Zip | 01760-0015
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Country | US
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Telephone | --
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TAKEIYA PERRY
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Credential | OPTICIAN, LDO
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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 | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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