Provider Demographics
NPI:1073252573
Name:AGAYBY-ZAKI, LIDYA (LDO)
Entity Type:Individual
Prefix:MRS
First Name:LIDYA
Middle Name:
Last Name:AGAYBY-ZAKI
Suffix:
Gender:F
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BIRCHMEADOW CIR
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-3709
Mailing Address - Country:US
Mailing Address - Phone:857-234-6115
Mailing Address - Fax:
Practice Address - Street 1:289 COUNTY ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-3512
Practice Address - Country:US
Practice Address - Phone:508-290-0050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6270156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty