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Individual

BRIAN SANGINARIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OPTICIAN

Contact information

Practice address
228 BILLERICA RD, CHELMSFORD, MA 01824-3604
(978) 250-6000
(978) 250-6460
Mailing address
147 MILK ST, PROVIDER ENROLLMENT DEPARTMENT - 9TH FLOOR, BOSTON, MA 02109-4806
(617) 421-2508
(617) 421-3487

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1962
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0324248
MA
Enumeration date
04/25/2007
Last updated
07/08/2007
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