Provider Demographics
NPI:1336300235
Name:CHERIAN, RITA A (OD)
Entity Type:Individual
Prefix:DR
First Name:RITA
Middle Name:A
Last Name:CHERIAN
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 1:669 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880-5221
Mailing Address - Country:US
Mailing Address - Phone:781-245-5200
Mailing Address - Fax:781-246-3932
Practice Address - Street 1:669 MAIN ST
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-5221
Practice Address - Country:US
Practice Address - Phone:781-245-5200
Practice Address - Fax:781-246-3932
Is Sole Proprietor?:No
Enumeration Date:2008-06-23
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002055152W00000X
MA4699152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist