Organization
WILMINGTON EYE GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALEX RUSSAKOVSKY O.D. (PRESIDENT)
(617) 285-4575
Entity
Organization
Contact information
Practice address
229 MAIN ST, PEARLE VISION, WILMINGTON, MA 01887-2302
(978) 658-8890
Mailing address
22 MCGRATH HWY # 4, PEARLE VISION, SOMERVILLE, MA 02143-4508
(617) 623-7522
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4635
MA
Other
Enumeration date
05/02/2014
Last updated
10/23/2014
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