Provider Demographics
NPI:1265424758
Name:PARIS-WHITNEY, STEPHANIE A (OD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:A
Last Name:PARIS-WHITNEY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 TRAPELO RD
Mailing Address - Street 2:SUITE 184
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-7333
Mailing Address - Country:US
Mailing Address - Phone:781-890-7797
Mailing Address - Fax:781-890-2507
Practice Address - Street 1:1601 TRAPELO RD
Practice Address - Street 2:SUITE 184
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-7333
Practice Address - Country:US
Practice Address - Phone:781-890-7797
Practice Address - Fax:781-890-2507
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3675152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
7704123OtherCIGNA
AA8378OtherHPHC
MAW22020OtherBCBS-MA
755280OtherTUFTS
42957Other1199 NATIONAL BENEFIT FUN
3442143OtherAETNA/US HEALTHCARE
W17395Medicare ID - Type Unspecified
AA8378OtherHPHC