Individual
ENIAN KALLAMATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD, MS
Contact information
Practice address
63 STATION LNDG, MEDFORD, MA 02155-5192
(781) 393-5367
(617) 453-5757
Mailing address
5 BLUE JAY CIR, BOSTON, MA 02126-1994
(857) 492-6188
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5418
MA
Other
Enumeration date
08/20/2020
Last updated
08/20/2020
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