Organization
HARVARD SQUARE EYE CARE P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAUREN DICKERMAN O.D. (PRESIDENT)
61733545590
Entity
Organization
Contact information
Practice address
19 DUNSTER ST, CAMBRIDGE, MA 02138-5002
(617) 354-5590
Mailing address
19 DUNSTER ST, CAMBRIDGE, MA 02138-5002
(617) 354-5590
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4211
MA
152WP0200X
Pediatric Optometrist
4211
MA
152WS0006X
Sports Vision Optometrist
4211
MA
156FC0800X
Contact Lens Technician/Technologist
4211
MA
156FC0801X
Contact Lens Fitter
4211
MA
156FX1800X
Optician
6165
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0334570
—
MA
Enumeration date
09/22/2007
Last updated
03/04/2008
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