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General NPI Number Information
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NPI Number | 1942933247
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Entity Type | Individual
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Provider Name | EMILY LEACH OD
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Gender | Female
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Dates
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Enumeration Date | 07/05/2022
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Last Update Date | 06/11/2024
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Provider Practice Location Address
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Address Line | 930 COMMONWEALTH AVE
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City | BOSTON
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State | MA
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Zip | 02215-1274
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Country | US
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Telephone | 617-262-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 37 ELM ST
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City | MELROSE
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State | MA
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Zip | 02176-2323
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Country | US
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Telephone | 857-206-2929
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 5548
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License Number State | MA
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