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General NPI Number Information
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NPI Number | 1962408278
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Entity Type | Organization
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Legal Business Name | GRODEN EYE CARE PC
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Dates
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Enumeration Date | 06/22/2005
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Last Update Date | 03/20/2015
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Provider Practice Location Address
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Address Line | 13 E HOYLE ST
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City | NORWOOD
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State | MA
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Zip | 02062-3405
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Country | US
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Telephone | 781-769-0987
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Fax | 781-769-0962
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Provider Business Mailing Address
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Address Line | 13 E HOYLE ST
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City | NORWOOD
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State | MA
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Zip | 02062-3405
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Country | US
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Telephone | 781-769-0987
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Fax | 781-769-0962
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | JOSEPH M GRODEN
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Credential | MD
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Telephone | 781-769-0987
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 42474
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License Number State | MA
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