Provider Demographics
NPI:1831420850
Name:KAY RICCIOTTI
Entity type:Organization
Organization Name:KAY RICCIOTTI
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAY
Authorized Official - Middle Name:R
Authorized Official - Last Name:RICCIOTTI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:978-537-6045
Mailing Address - Street 1:867 MERRIAM AVE
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453
Mailing Address - Country:US
Mailing Address - Phone:978-537-6045
Mailing Address - Fax:978-534-9845
Practice Address - Street 1:867 MERRIAM AVE
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453
Practice Address - Country:US
Practice Address - Phone:978-537-6045
Practice Address - Fax:978-534-9845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-15
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty