Individual
MARK W O'DONOGHUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
930 COMMONWEALTH AVE SUITE 2A, NEW ENGLAND EYE COMMONWEALTH, BOSTON, MA 02215
(617) 262-2020
(617) 236-6323
Mailing address
940 COMMONWEALTH AVE SUITE 2, NEW ENGLAND EYE INSTITUTE, BOSTON, MA 02215
(617) 587-5511
(617) 236-6323
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3023
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0346322
—
MA
01
—
152627
HARVARD PILGRAM HLTH CARE
—
01
—
755398
TUFTS HEALTH PLAN
—
01
—
AA62951
HARVARD PILGRAM
—
01
—
W15574
BLUE CROSS B S OF MA
—
Enumeration date
06/15/2006
Last updated
04/15/2010
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