Provider Demographics
NPI:1861660227
Name:DR. HARLAND ROBINSON III
Entity Type:Organization
Organization Name:DR. HARLAND ROBINSON III
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HARLAND
Authorized Official - Middle Name:W
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:III
Authorized Official - Credentials:OD
Authorized Official - Phone:781-665-0897
Mailing Address - Street 1:490 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:MA
Mailing Address - Zip Code:02176-3841
Mailing Address - Country:US
Mailing Address - Phone:781-665-0897
Mailing Address - Fax:781-665-8828
Practice Address - Street 1:490 MAIN ST
Practice Address - Street 2:
Practice Address - City:MELROSE
Practice Address - State:MA
Practice Address - Zip Code:02176-3841
Practice Address - Country:US
Practice Address - Phone:781-665-0897
Practice Address - Fax:781-665-8828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2269152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000362OtherVISION SERVICE PLAN
MA0396575Medicaid
MA0564770001OtherDME
MA84357OtherUS HEALTH
MARO013458OtherMEDICARE-TYPE UNSPECIFIED
MA716342OtherTUFTS
MA70010000W20130OtherBCBSMA
MA716342OtherTUFTS