Individual
NIMIRA SAMJI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
139 ENDICOTT ST, ENDICOTT PLAZA, DANVERS, MA 01923-2515
(978) 777-4700
(978) 750-0862
Mailing address
139 ENDICOTT ST, ENDICOTT PLAZA, DANVERS, MA 01923-2515
(978) 777-4700
(978) 750-0862
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
046010253
IL
152W00000X
Optometrist
Primary
4108
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0335771
—
MA
01
—
046010253
ILLINOIS OPTOMETRY LICENSE
IL
01
—
346003017
ILLINOIS CONTROLLED SUBSTANCE
IL
01
—
4108
MASSACHUSETTS OPTOMETRY LICENSE
MA
01
—
W16375
BCBS
MA
Enumeration date
11/21/2006
Last updated
05/30/2023
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