Provider Demographics
NPI:1356414205
Name:FRIZZELL LEWIS, KAREN LORING (OD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:LORING
Last Name:FRIZZELL LEWIS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:KAREN
Other - Middle Name:LORING
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:24 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915
Mailing Address - Country:US
Mailing Address - Phone:978-927-3650
Mailing Address - Fax:
Practice Address - Street 1:3 CENTRAL SQUARE
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139
Practice Address - Country:US
Practice Address - Phone:617-225-2258
Practice Address - Fax:617-497-2025
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3145152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
11456303OtherCAQH CREDENTIALING CO
MAAA37222OtherHARVARD PILGRIM
MA494820OtherTUFTS HEALTHPLAN
MA2025036001OtherCIGNA
MA911256OtherEYE MED
MA0707121Medicaid
MA5029027OtherATENA
MAW16085OtherBLUE CROSS
MA0707121Medicaid