Individual
CHERYL DEPALO A JOST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1 PORTER SQ, CAMBRIDGE, MA 02140-1431
(617) 864-7005
Mailing address
350 MYLES STANDISH BLVD, SUITE 201, TAUNTON, MA 02780-7387
(508) 823-9307
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4351
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3398327
AETNA
MA
01
—
4351
LICENSE NUMBER
MA
01
—
468669
TUFTS
MA
01
—
AA3300
HARVARD PILGRIM
MA
01
—
W22057
BLUE CROSS BLUE SHIELD
MA
Enumeration date
09/13/2006
Last updated
08/27/2015
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