Individual
LINDA GULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OPTICIAN
Contact information
Practice address
147 MILK ST, BOSTON, MA 02109-4806
(617) 654-7000
(617) 482-3872
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
4463
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0336050
—
MA
Enumeration date
04/25/2007
Last updated
04/23/2015
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