Provider Demographics
NPI:1700923687
Name:OPHTHALMIC CONSULTANTS OF BOSTON, INC
Entity Type:Organization
Organization Name:OPHTHALMIC CONSULTANTS OF BOSTON, INC
Other - Org Name:OCB OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDERMOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-314-2672
Mailing Address - Street 1:50 STANIFORD ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2517
Mailing Address - Country:US
Mailing Address - Phone:617-722-0220
Mailing Address - Fax:617-589-0553
Practice Address - Street 1:50 STANIFORD ST
Practice Address - Street 2:SUITE 600
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2517
Practice Address - Country:US
Practice Address - Phone:617-722-0220
Practice Address - Fax:617-589-0553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0720980001Medicare NSC