Individual
TINA S CLEARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
50 STANIFORD ST, SUITE 600, BOSTON, MA 02114-2517
(617) 367-4800
(617) 723-7028
Mailing address
50 STANIFORD ST, SUITE 600, BOSTON, MA 02114-2517
(617) 367-4800
(617) 723-7028
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
220298
MA
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
220298
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2074664
—
MA
01
—
A3720702
PTAN
MA
01
—
J28155
BCBS MA
MA
Enumeration date
02/13/2006
Last updated
12/20/2021
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