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Individual

DR. STACY E BEAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
40 ENON ST, BEVERLY, MA 01915-1168
(978) 922-7120
Mailing address
5 PRINCETON ST, PEABODY, MA 01960-1408
(978) 977-0190

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3778
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0392057
MA
Enumeration date
02/24/2006
Last updated
05/25/2016
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