Provider Demographics
NPI:1174974380
Name:ASGHARI, BITA
Entity type:Individual
Prefix:
First Name:BITA
Middle Name:
Last Name:ASGHARI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:464 HILLSIDE AVENUE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02494
Mailing Address - Country:US
Mailing Address - Phone:781-726-7337
Mailing Address - Fax:781-726-7311
Practice Address - Street 1:464 HILLSIDE AVE STE 205
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02494-1228
Practice Address - Country:US
Practice Address - Phone:781-726-7337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6440152W00000X, 152WC0802X
MA5255152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management