Provider Demographics
NPI:1851867733
Name:SANCHEZ, ANGELA (LDO)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 BARR RD
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-4609
Mailing Address - Country:US
Mailing Address - Phone:978-587-1397
Mailing Address - Fax:
Practice Address - Street 1:111 EVERETT AVE
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MA
Practice Address - Zip Code:02150-2385
Practice Address - Country:US
Practice Address - Phone:617-884-0456
Practice Address - Fax:671-884-0457
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-18
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6605156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician