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General NPI Number Information
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NPI Number | 1902047103
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Entity Type | Organization
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Legal Business Name | LESLIE K CAREY OD LLC
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Dates
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Enumeration Date | 03/18/2009
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Last Update Date | 02/07/2013
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Provider Practice Location Address
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Address Line | 37 MAPLE ST
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City | DANVERS
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State | MA
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Zip | 01923-2851
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Country | US
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Telephone | 978-777-0379
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Fax | 978-762-4934
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Provider Business Mailing Address
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Address Line | 35 ELM ST
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City | DANVERS
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State | MA
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Zip | 01923-2835
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Country | US
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Telephone | 978-777-0379
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Fax | 978-762-4934
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Authorized Official
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Title or Position | OWNER
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Name | LESLIE K CAREY
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Credential | OD
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Telephone | 978-777-0379
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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 | 3512
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License Number State | MA
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