Provider Demographics
NPI:1093200545
Name:SOKOL, MAGEN MARY
Entity Type:Individual
Prefix:
First Name:MAGEN
Middle Name:MARY
Last Name:SOKOL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MAGEN
Other - Middle Name:MARY
Other - Last Name:HARTNETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:50 STANIFORD ST STE 600
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2587
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:50 STANIFORD ST STE 600
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2539
Practice Address - Country:US
Practice Address - Phone:610-349-3690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-27
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5310152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist