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NPI Code Detail

MEDICARE: LUMEN VISION CARE

MEDICARE: LUMEN VISION CARE
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
1152W00000XOptometrist

General Provider Information

NPI Number : 1821875279
Entity Type Code : Organization
Provider Name (Legal Business Name) : LUMEN VISION CARE
Provider Business Mailing Address
First Line : 95 WASHINGTON ST STE 466
Second Line :
City : CANTON
State : MA
Zip : 02021-4008
Country : US
Telephone Number : 508-257-1516
Fax Number :
Provider Business Practice Location Address
First Line : 95 WASHINGTON ST STE 466
Second Line :
City : CANTON
State : MA
Zip : 02021-4008
Country : US
Telephone Number : 781-462-1719
Fax Number :
Authorized Official
Title or Position : OPTOMETRIST
Name : JANA WEGRZYN
Credential :
Telephone Number : 508-257-1516
Provider Enumeration Date : 09/11/2023
Last Update Date : 10/15/2023

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Directions to “LUMEN VISION CARE ” Practice Location

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