Individual
DR. RONALD KIYOSHI WATANABE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
15 CENTRAL ST, ANDOVER, MA 01810-3718
(978) 475-5252
(978) 475-2226
Mailing address
15 CENTRAL ST, ANDOVER, MA 01810-3718
(978) 475-5252
(978) 475-2226
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3763
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
153220
HARVARD PILGRIM
MA
01
—
1552937
COVENTRY
MA
05
—
317390
—
MA
01
—
402787
TUFTS
MA
01
—
54742
FALLON
MA
01
—
610461
COMP BENEFITS
—
01
—
W16025
BCBS
MA
Enumeration date
07/28/2005
Last updated
08/23/2010
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