Provider Demographics
NPI:1821426354
Name:MASS OPTOMETRIC ASSOCAITES, PC
Entity Type:Organization
Organization Name:MASS OPTOMETRIC ASSOCAITES, PC
Other - Org Name:MASS OPTOMETRIC ASSOCIATES PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEARSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-524-6982
Mailing Address - Street 1:PO BOX 29900
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-9907
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2421 CRANBERRY HWY
Practice Address - Street 2:SUITE 210
Practice Address - City:WAREHAM
Practice Address - State:MA
Practice Address - Zip Code:02571-5021
Practice Address - Country:US
Practice Address - Phone:508-273-0107
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-18
Last Update Date:2013-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty