Individual
MRS. JANICE SIRIMA PAKNEJAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
372 WASHINGTON ST, BRIGHTON, MA 02135-2725
(617) 782-6650
(617) 782-2660
Mailing address
19038 BRASILIA DR, NORTHRIDGE, CA 91326-1520
(818) 836-2299
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
12947
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0705691
MASSHEALTH
MA
01
—
478947
TUFTS
MA
01
—
W16450
BCBS
MA
Enumeration date
08/31/2006
Last updated
11/14/2018
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