Provider Demographics
NPI:1578714150
Name:AFSHAR, SURAJ SADEGHI (OD)
Entity Type:Individual
Prefix:DR
First Name:SURAJ
Middle Name:SADEGHI
Last Name:AFSHAR
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:479 OLD UNION TPKE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:MA
Mailing Address - Zip Code:01523-3029
Mailing Address - Country:US
Mailing Address - Phone:978-537-3900
Mailing Address - Fax:978-537-6030
Practice Address - Street 1:479 OLD UNION TPKE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:MA
Practice Address - Zip Code:01523-3029
Practice Address - Country:US
Practice Address - Phone:978-537-3900
Practice Address - Fax:978-537-6030
Is Sole Proprietor?:No
Enumeration Date:2008-10-01
Last Update Date:2014-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0821152W00000X
MA4714152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist