Provider Demographics
NPI:1659497782
Name:LABIENTO SMITH, LORRAINE (OD)
Entity Type:Individual
Prefix:DR
First Name:LORRAINE
Middle Name:
Last Name:LABIENTO SMITH
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 1:344 BOSTON POST RD
Mailing Address - Street 2:
Mailing Address - City:SUDBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01776-3007
Mailing Address - Country:US
Mailing Address - Phone:978-443-3021
Mailing Address - Fax:
Practice Address - Street 1:344 BOSTON POST ROAD
Practice Address - Street 2:SUDBURY EYE CARE
Practice Address - City:SUDBURY
Practice Address - State:MA
Practice Address - Zip Code:01776
Practice Address - Country:US
Practice Address - Phone:978-443-3021
Practice Address - Fax:978-610-2620
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4334152W00000X, 152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0718688Medicaid
MA0718688Medicaid