Provider Demographics
NPI:1750355467
Name:NAU, AMY CATHERINE (OD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:CATHERINE
Last Name:NAU
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 1:400 COMMONWEALTH AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-2813
Mailing Address - Country:US
Mailing Address - Phone:617-426-0370
Mailing Address - Fax:617-426-5119
Practice Address - Street 1:400 COMMONWEALTH AVE STE 2
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-2813
Practice Address - Country:US
Practice Address - Phone:617-426-0370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4212152W00000X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU85979Medicare UPIN
PA069798FFFMedicare ID - Type Unspecified