Provider Demographics
NPI:1326325168
Name:LEIN-THU VAN DAO
Entity Type:Organization
Organization Name:LEIN-THU VAN DAO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEIN-THU
Authorized Official - Middle Name:VAN
Authorized Official - Last Name:DAO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:978-374-0386
Mailing Address - Street 1:14 WILCOX RD
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER CENTER
Mailing Address - State:MA
Mailing Address - Zip Code:02124-5022
Mailing Address - Country:US
Mailing Address - Phone:617-888-9920
Mailing Address - Fax:978-372-3631
Practice Address - Street 1:72 MERRIMACK ST
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-6207
Practice Address - Country:US
Practice Address - Phone:978-374-0386
Practice Address - Fax:978-372-3631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-08
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA4806152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty