Individual
DR. JAMES HOVANNES FANTAZIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
247 BOSTON RD, N BILLERICA, MA 01862
(978) 667-6151
(978) 667-4422
Mailing address
PO BOX 356, 247 BOSTON RD, N BILLERICA, MA 01862
(978) 667-6151
(978) 667-4422
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2093
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0304999
—
MA
Enumeration date
09/26/2006
Last updated
07/08/2007
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