Provider Demographics
NPI:1407872260
Name:LAHIVE, JAMES PAUL (OD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:PAUL
Last Name:LAHIVE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:888 WORCESTER ST
Mailing Address - Street 2:SUITE 130
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02482-3744
Mailing Address - Country:US
Mailing Address - Phone:617-964-6681
Mailing Address - Fax:339-686-2561
Practice Address - Street 1:888 WORCESTER ST
Practice Address - Street 2:SUITE 130
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02482-3744
Practice Address - Country:US
Practice Address - Phone:617-964-6681
Practice Address - Fax:888-662-0859
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA3297152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0393673Medicaid
MA410025558OtherMEDICARE RAILROAD
MAW15766OtherBLUE CROSS BLUE SHIELD
MA0393673Medicaid
MAW15766OtherBLUE CROSS BLUE SHIELD