Provider Demographics
NPI:1922044916
Name:NIRO, JOSEPH M (OD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:M
Last Name:NIRO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 HAGER LN
Mailing Address - Street 2:
Mailing Address - City:BOXBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01719-1827
Mailing Address - Country:US
Mailing Address - Phone:978-263-8521
Mailing Address - Fax:978-263-7319
Practice Address - Street 1:296 GREAT RD
Practice Address - Street 2:
Practice Address - City:ACTON
Practice Address - State:MA
Practice Address - Zip Code:01720-4710
Practice Address - Country:US
Practice Address - Phone:978-263-8521
Practice Address - Fax:978-263-7319
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3185152W00000X, 152WC0802X, 152WP0200X, 152WS0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WS0006XEye and Vision Services ProvidersOptometristSports Vision
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA409201OtherTUFTS HEALTH PLAN
MA545688OtherFIRST HEALTH
MA0031070OtherNEIGHBORHOOD HEALTH
MA22-00535OtherUNITED HEALTH CARE
MAMA0012217OtherTRICARE
MAW15890OtherBCBS
MA237340OtherHEALTHSOURCE
MA409201OtherMEDICARE PREFERRED TUFTS
MA1053355OtherFALLON
MA152114OtherHPHC
MA5330691OtherAETNA
MA0356212Medicaid
MA3137132-001OtherCIGNA
MA409201OtherTUFTS HEALTH PLAN
MAN1459558Medicare ID - Type Unspecified