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Individual

IASON S MANTAGOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
300 LONGWOOD AVE, FEGAN 4, BOSTON, MA 02115
(617) 355-6401
(617) 730-0392
Mailing address
300 LONGWOOD AVE, FEGAN 4, BOSTON, MA 02115
(617) 355-6401

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
234820
MA
207WX0110X
Pediatric Ophthalmology and Strabismus Specialist Physician
234820
MA

Other

Enumeration date
05/13/2008
Last updated
04/29/2020
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