Individual
SIRI BOONSIRISERMSOOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
75 MAIN ST, STONEHAM, MA 02180-3305
(781) 438-3372
(781) 438-3050
Mailing address
75 MAIN ST, STONEHAM, MA 02180-3305
(781) 438-3372
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4307
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7614498
AETNA PROVIDER NUMBER
MA
01
—
AA29247
HARVARD PILGRIM
MA
01
—
MA4307
EYE MED VISION CARE
MA
01
—
W16362
BLUE CROSS BLUE SHIELD
MA
Enumeration date
11/03/2006
Last updated
07/09/2007
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