Provider Demographics
NPI:1932362316
Name:FARJAD, HELEN
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:
Last Name:FARJAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9211 STATION CIR
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-4592
Mailing Address - Country:US
Mailing Address - Phone:617-309-0111
Mailing Address - Fax:
Practice Address - Street 1:688 PROVIDENCE HWY
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-6800
Practice Address - Country:US
Practice Address - Phone:781-329-4514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-07
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT 13786 TLG152W00000X
MA4733152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist