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General NPI Number Information
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NPI Number | 1790574739
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Entity Type | Organization
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Legal Business Name | RETINA SPECIALISTS OF BOSTON AND WELLESLEY LLC
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Dates
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Enumeration Date | 05/05/2025
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 1 WASHINGTON ST STE 300
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City | WELLESLEY HILLS
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State | MA
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Zip | 02481-1706
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Country | US
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Telephone | 617-256-7684
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Fax |
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Provider Business Mailing Address
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Address Line | 1 WASHINGTON ST STE 300
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City | WELLESLEY HILLS
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State | MA
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Zip | 02481-1706
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Country | US
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Telephone | 617-256-7684
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CAROLINE BAUMAL
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Credential |
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Telephone | 617-256-7684
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number |
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License Number State |
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