Provider Demographics
NPI:1831504133
Name:HERALD, CHRISTINA MARIE (OD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:MARIE
Last Name:HERALD
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:MARIE
Other - Last Name:BUONOMO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:3950 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-1679
Mailing Address - Country:US
Mailing Address - Phone:508-673-2370
Mailing Address - Fax:508-673-5834
Practice Address - Street 1:3950 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-1679
Practice Address - Country:US
Practice Address - Phone:508-673-2370
Practice Address - Fax:508-673-5834
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-25
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5023152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist