Provider Demographics
NPI:1043212087
Name:KARALEKAS, CHRISTOPHER A (OD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:A
Last Name:KARALEKAS
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 1:291 DALE ST
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-2953
Mailing Address - Country:US
Mailing Address - Phone:617-610-8055
Mailing Address - Fax:978-458-4546
Practice Address - Street 1:850 CHELMSFORD ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01851-5149
Practice Address - Country:US
Practice Address - Phone:978-452-0127
Practice Address - Fax:978-452-1749
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3863152W00000X, 152WL0500X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA31932OtherFALLON HEALTH PLAN
MA365495OtherHEALTH SOURCE MASS
MA980956OtherNETWORK HEALTH
MA0006473OtherNEIGHBORHOOD HEALTH PLAN
MA0369365Medicaid
MA151430OtherHARVARD COMMUNITY HP
NH21613OtherANTHEM BC/BS
MA7625OtherDAVIS VISION
B20884301OtherCIGNA
MAW16129OtherHMOBLUE/MASS.
MAW16129OtherBC/BS OF MASS.
MA042489265OtherPHCS
MAW20210OtherBC/BS INDEMINITY
MA759053OtherTUFTS HEALTH PLAN
MA7625OtherDAVIS VISION
B20884301OtherCIGNA
MA410042888Medicare ID - Type UnspecifiedRR MEDICARE