Provider Demographics
NPI:1679809420
Name:ALVITI, PAUL (RDO # 4108)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:ALVITI
Suffix:
Gender:M
Credentials:RDO # 4108
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2 ESSEX CENTER DR
Mailing Address - Street 2:OPTICAL SERVICES
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-2930
Mailing Address - Country:US
Mailing Address - Phone:978-977-4140
Mailing Address - Fax:978-977-4057
Practice Address - Street 1:2 ESSEX CENTER DR
Practice Address - Street 2:OPTICAL SERVICES
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-2930
Practice Address - Country:US
Practice Address - Phone:978-977-4140
Practice Address - Fax:978-977-4057
Is Sole Proprietor?:No
Enumeration Date:2009-10-29
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA4108156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician