Provider Demographics
NPI:1043205834
Name:ZIDE, ARNOLD STEVEN (OD)
Entity Type:Individual
Prefix:DR
First Name:ARNOLD
Middle Name:STEVEN
Last Name:ZIDE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 MIDDLE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01772-1035
Mailing Address - Country:US
Mailing Address - Phone:508-801-3597
Mailing Address - Fax:617-542-2021
Practice Address - Street 1:160 FEDERAL STREET SUITE C1C
Practice Address - Street 2:VISION CARE 2000
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02110
Practice Address - Country:US
Practice Address - Phone:614-542-2015
Practice Address - Fax:617-542-2021
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-16
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2670 TP152WC0802X, 152WS0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WS0006XEye and Vision Services ProvidersOptometristSports Vision
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0334286Medicaid
MAT59252Medicare UPIN
MA0334286Medicaid