Organization
BAYSTATE EYE ASSOCIATES OF LEOMINSTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID KAHAN OD (OWNER)
(508) 837-3790
Entity
Organization
Contact information
Practice address
25 SACK BLVD, LEOMINSTER, MA 01453-3325
(978) 537-2270
(978) 534-3478
Mailing address
25 SACK BLVD, LEOMINSTER, MA 01453-3325
(508) 837-3790
(978) 534-3478
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2384
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110067924/B
—
MA
05
—
9745564
—
MA
01
—
99828201
NETHEALTH
MA
Enumeration date
08/19/2006
Last updated
04/07/2020
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