Provider Demographics
NPI:1922647403
Name:EVANS, CLAUDIA CHRISTINE (OD)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:CHRISTINE
Last Name:EVANS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:CLAUDIA
Other - Middle Name:
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:8 GLOUCESTER ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-1720
Mailing Address - Country:US
Mailing Address - Phone:517-267-5228
Mailing Address - Fax:
Practice Address - Street 1:8 GLOUCESTER ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-1720
Practice Address - Country:US
Practice Address - Phone:517-267-5228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-31
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2466-OP-TPA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist