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General NPI Number Information
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NPI Number | 1912006495
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Entity Type | Organization
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Legal Business Name | L&D EYE ASSOCIATES
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 08/26/2008
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Provider Practice Location Address
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Address Line | 9 MARKET STREET
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City | MASHPEE
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State | MA
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Zip | 02649
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Country | US
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Telephone | 508-477-7423
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Fax | 508-477-0584
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Provider Business Mailing Address
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Address Line | PO BOX 1410
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City | MASHPEE
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State | MA
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Zip | 02649-1410
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Country | US
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Telephone | 508-477-7423
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Fax | 508-477-0584
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. ALAN E. LEAVITT
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Credential | M.D.
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Telephone | 508-477-7423
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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 | 3355
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License Number State | MA
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