MEDICARE: MASS OPTOMETRIC ASSOCIATES, PLLC

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	332H00000X	Eyewear Supplier
2	152W00000X	Optometrist

General Provider Information

NPI Number	:	1972059723
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MASS OPTOMETRIC ASSOCIATES, PLLC

Provider Business Mailing Address
First Line	:	PO BOX 417821
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02241-7821
Country	:	US
Telephone Number	:	800-349-5120
Fax Number	:	210-524-6587

Provider Business Practice Location Address
First Line	:	228 WASHINGTON ST
Second Line	:	STE A100
City	:	ATTLEBORO
State	:	MA
Zip	:	02703-5518
Country	:	US
Telephone Number	:	210-524-6922
Fax Number	:	210-524-6587

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RANDI FRANKL
Credential	:
Telephone Number	:	516-815-1646

Provider Enumeration Date	:	08/31/2016
Last Update Date	:	09/20/2024

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