| NPI | 1770679045 |
|---|---|
| Former Legal Business Name | PEDIATRIC OPHTHALMOLOGY SERVICE |
| Entity Type | Organization |
| Authorized Contact | LUCIA P DAVIDSON Billing Manager 617-355-6405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2022-09-26 |