Individual
AILEEN MARIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
360 MERRIMACK ST, BLDG 9, LAWRENCE, MA 01843-1740
(978) 688-6182
(978) 689-0731
Mailing address
360 MERRIMACK ST, BLDG 9, LAWRENCE, MA 01843-1740
(978) 688-6182
(978) 689-0731
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
0743
NH
152W00000X
Optometrist
Primary
4319
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0337081
—
MA
05
—
30352264
—
NH
Enumeration date
11/21/2005
Last updated
09/25/2021
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