Provider Demographics
NPI:1992358048
Name:BOSTON EYE BLINK LLC
Entity Type:Organization
Organization Name:BOSTON EYE BLINK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:YUERAN
Authorized Official - Middle Name:
Authorized Official - Last Name:YAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:617-651-6662
Mailing Address - Street 1:200 LEGACY BLVD
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-2653
Mailing Address - Country:US
Mailing Address - Phone:617-651-6662
Mailing Address - Fax:781-459-7990
Practice Address - Street 1:200 LEGACY BLVD
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-2653
Practice Address - Country:US
Practice Address - Phone:617-651-6662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-18
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty