Provider Demographics
NPI:1982673588
Name:PARSEGHIAN, REEM R (OD)
Entity Type:Individual
Prefix:DR
First Name:REEM
Middle Name:R
Last Name:PARSEGHIAN
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 1:31 CENTENNIAL DR
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-7901
Mailing Address - Country:US
Mailing Address - Phone:978-531-4400
Mailing Address - Fax:978-531-7106
Practice Address - Street 1:31 CENTENNIAL DR
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-7901
Practice Address - Country:US
Practice Address - Phone:978-531-4400
Practice Address - Fax:978-531-7106
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004019133152W00000X
NY6346152W00000X
MA4742152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
31657OtherOPTICARE MED. COMPLETE
MO319277208Medicaid
193021OtherBLUE CROSS BLUE SHIELD MO
MO31927721Medicaid
UNKNOWNOtherUNITED HEALTHCARE
225922OtherGROUP HEALTH PLAN
MO193021OtherBLUE CHOICE
MO52097OtherHEALTHCARE USA
682692OtherHEALTHLINK
193021OtherBLUE CROSS BLUE SHIELD MO
MO257491722Medicare ID - Type Unspecified