MEDICARE: CAROL A. WEIL O.D., RPT

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	3553	MA

General Provider Information

NPI Number	:	1376706820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL A. WEIL O.D., RPT

Provider Business Mailing Address
First Line	:	214 LINCOLN ST
Second Line	:	SUITE 205
City	:	ALLSTON
State	:	MA
Zip	:	02134-1347
Country	:	US
Telephone Number	:	617-782-0100
Fax Number	:	617-782-1702

Provider Business Practice Location Address
First Line	:	214 LINCOLN ST
Second Line	:	SUITE 205
City	:	ALLSTON
State	:	MA
Zip	:	02134-1347
Country	:	US
Telephone Number	:	617-782-0100
Fax Number	:	617-782-1702

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

Provider Enumeration Date	:	07/04/2008
Last Update Date	:	07/04/2008

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