Individual
AIMEE KOREN GRAY PICKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
40 INDUSTRIAL PARK RD, PLYMOUTH, MA 02360-4884
(508) 746-8600
(508) 747-0824
Mailing address
40 INDUSTRIAL PARK RD, PLYMOUTH, MA 02360-4884
(508) 746-8600
(508) 747-0824
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4197
MA
152W00000X
Optometrist
4901004182
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110014827A
—
MA
01
—
110955
EYE MED
—
01
—
7368965
CIGNA
MA
01
—
900E06513
BCBS
—
01
—
AA227707
HARVARD PILGRIM
MA
01
—
W1736901
MEDICARE, NHIC
MA
Enumeration date
04/10/2007
Last updated
09/19/2016
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