MEDICARE: LIXIN ZHENG

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	4978	MA

General Provider Information

NPI Number	:	1619371572
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIXIN ZHENG

Provider Business Mailing Address
First Line	:	466 TRAPELO RD
Second Line	:	A
City	:	BELMONT
State	:	MA
Zip	:	02478-1421
Country	:	US
Telephone Number	:	617-489-3790
Fax Number	:	617-489-1860

Provider Business Practice Location Address
First Line	:	466 TRAPELO RD
Second Line	:	A
City	:	BELMONT
State	:	MA
Zip	:	02478-1421
Country	:	US
Telephone Number	:	617-489-3790
Fax Number	:	617-489-1860

Authorized Official
Title or Position	:	OWNER
Name	:	DR. LIXIN ZHENG
Credential	:	O.D.
Telephone Number	:	617-489-3790

Provider Enumeration Date	:	10/21/2014
Last Update Date	:	11/06/2016

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