Individual
HA TIEN LE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D
Contact information
Practice address
1350 DORCHESTER AVE, DORCHESTER, MA 02122-2912
(617) 265-0728
(617) 265-0931
Mailing address
1350 DORCHESTER AVE, DORCHESTER, MA 02122-2912
(617) 265-0728
(617) 265-0931
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4927
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ML0889470M
CONTROLLED SUBSTANCE REGISTRATION NUMBER
MA
Enumeration date
08/03/2012
Last updated
05/23/2014
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