Individual
ELISE D'AMIANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
6 W MILL ST FL 1, MEDFIELD, MA 02052-1507
(508) 359-4164
(508) 359-2860
Mailing address
20 ALDEN RD, WAYLAND, MA 01778-3729
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3708
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110013238A
—
MA
01
—
22-00448
UNITED
—
01
—
2258529
CIGNA
—
01
—
759055
TUFTS
—
01
—
AA15548
HPHC
—
01
—
W15980
BCBS
—
Enumeration date
12/06/2006
Last updated
02/06/2019
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