Provider Demographics
NPI:1790447423
Name:SLEPCHUK, ZACHARY (OD)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:
Last Name:SLEPCHUK
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 BEACON ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-1129
Mailing Address - Country:US
Mailing Address - Phone:617-266-2030
Mailing Address - Fax:
Practice Address - Street 1:386 W BROADWAY
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02127-2215
Practice Address - Country:US
Practice Address - Phone:617-464-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-11
Last Update Date:2025-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5509152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist