Individual
DR. NICOLE CHRISTIE ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
930 COMMONWEALTH AVE, SUITE 2A, BOSTON, MA 02215-1220
(617) 262-2020
(617) 236-6323
Mailing address
200 WOODVIEW WAY, APT 214, WATERTOWN, MA 02472
(617) 869-4317
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TA2297
MD
152WL0500X
Low Vision Rehabilitation Optometrist
5047
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
055783800
—
MD
05
—
110100998A
—
MA
Enumeration date
08/16/2011
Last updated
02/11/2016
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