Organization
KENMORE OPTICAL
Active
Other names
KENMORE OPTICAL
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN O'SHEA O.D. (OWNER OPTOMETRIST)
(508) 380-8966
Entity
Organization
Contact information
Practice address
1018 BEACON ST STE 100, BROOKLINE, MA 02446-4058
(617) 536-7870
Mailing address
1018 BEACON ST STE 100, BROOKLINE, MA 02446-4058
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1821109703
—
MA
Enumeration date
01/19/2021
Last updated
01/19/2021
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