Provider Demographics
NPI:1235110941
Name:TOOMEY-GITTO, CAROLINE (OD)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:TOOMEY-GITTO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 COMMONWEALTH AVENUE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215
Mailing Address - Country:US
Mailing Address - Phone:617-587-5511
Mailing Address - Fax:617-587-5514
Practice Address - Street 1:799 WEST BOYLSTON STREET
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01606
Practice Address - Country:US
Practice Address - Phone:617-587-5511
Practice Address - Fax:617-587-5514
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3377152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0353876Medicaid
MA2855138OtherCIGNA
MA4667155OtherAETNA
MAMA3377OtherEYEMED
MA150557OtherHARVARD PILGRIM
042621019OtherCORP TAX ID
MA0353876OtherMASS HEALTH
MA0353876OtherMASS HEALTH
042621019OtherCORP TAX ID