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Individual

ANGHELO GUEVARA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1601 WASHINGTON ST, BOSTON, MA 02118-1951
(617) 425-2020
(617) 425-2023
Mailing address
1601 WASHINGTON ST, BOSTON, MA 02118-1951
(617) 425-2020
(617) 425-2023

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
6472
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6472
COMMONWEALTH OF MASSACHUSETTS BOARD OF DISPENSING OPTICIANS
MA
Enumeration date
05/04/2016
Last updated
05/04/2016
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