MEDICARE: BITA ASGHARI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	6440	OH
2	152WC0802X	Corneal and Contact Management Optometrist	6440	OH
3	152W00000X	Optometrist	5255	MA

General Provider Information

NPI Number	:	1174974380
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BITA ASGHARI

Provider Business Mailing Address
First Line	:	464 HILLSIDE AVENUE
Second Line	:	SUITE 205
City	:	NEEDHAM
State	:	MA
Zip	:	02494
Country	:	US
Telephone Number	:	781-726-7337
Fax Number	:	781-726-7311

Provider Business Practice Location Address
First Line	:	464 HILLSIDE AVE STE 205
Second Line	:
City	:	NEEDHAM
State	:	MA
Zip	:	02494-1228
Country	:	US
Telephone Number	:	781-726-7337
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2016
Last Update Date	:	07/21/2022

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Directions to “ BITA ASGHARI ” Practice Location

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