Provider Demographics
NPI:1174501589
Name:SYMOLON, ANNA (OD)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:
Last Name:SYMOLON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:SOKOLOWSKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:250 NORTHAMPTON ST
Mailing Address - Street 2:APT. D
Mailing Address - City:EASTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01027-1197
Mailing Address - Country:US
Mailing Address - Phone:413-527-9284
Mailing Address - Fax:
Practice Address - Street 1:250 NORTHAMPTON ST STE D
Practice Address - Street 2:
Practice Address - City:EASTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01027-1198
Practice Address - Country:US
Practice Address - Phone:413-527-9284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-05
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004018730152W00000X
MA4648152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist