Individual
GREGORY R. BLAHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
ONE ESSEX CENTER DRIVE, LAHEY CLINIC, PEABODY, MA 01960-2901
(978) 538-4400
(978) 538-4724
Mailing address
ONE ESSEX CENTER DRIVE, LAHEY CLINIC, PEABODY, MA 01960-2901
(978) 538-4400
(978) 538-4724
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
221050
MA
207WX0107X
Retina Specialist (Ophthalmology) Physician
221050
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110037878A
—
MA
Enumeration date
09/29/2006
Last updated
05/10/2019
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