Provider Demographics
NPI:1346392990
Name:CHAU, TAK-YIN (OD)
Entity Type:Individual
Prefix:
First Name:TAK-YIN
Middle Name:
Last Name:CHAU
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:TAK
Other - Middle Name:Y
Other - Last Name:CHAU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:15 JOYCE RD
Mailing Address - Street 2:
Mailing Address - City:WAYLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01778-4515
Mailing Address - Country:US
Mailing Address - Phone:508-650-3505
Mailing Address - Fax:
Practice Address - Street 1:133 LITTLETON RD
Practice Address - Street 2:SUITE 204
Practice Address - City:WESTFORD
Practice Address - State:MA
Practice Address - Zip Code:01886-3198
Practice Address - Country:US
Practice Address - Phone:978-589-9919
Practice Address - Fax:978-589-9921
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5676152W00000X
MA3659152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA153362OtherHARVARD PILGRIM
MA4893790OtherCIGNA
MA0335801Medicaid
MAW16273OtherBCBS
MA2217847OtherUNITED HEALTHCARE
MA461428OtherTUFT
MA99407OtherFALLON
MA0335801Medicaid
MA99407OtherFALLON