Provider Demographics
NPI:1770678732
Name:LAMOREAU, KRISTEN PAGE (OD, MA)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:PAGE
Last Name:LAMOREAU
Suffix:
Gender:F
Credentials:OD, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:11 NEVINS ST
Mailing Address - Street 2:NEW ENGLAND EYE CENTER, SUITE 205
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-3514
Mailing Address - Country:US
Mailing Address - Phone:617-783-5050
Mailing Address - Fax:617-783-0734
Practice Address - Street 1:11 NEVINS ST
Practice Address - Street 2:NEW ENGLAND EYE CENTER, SUITE 205
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-3514
Practice Address - Country:US
Practice Address - Phone:617-783-5050
Practice Address - Fax:617-783-0734
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4584152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9758050OtherAETNA
MA2137615Medicaid
MA000136001OtherMEDICARE PTAN
MAMA 4584OtherEYEMED
MAW16512OtherBLUE CROSS BLUE SHIELD