Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 2670 TP | MA |
N | 152WS0006X | Sports Vision | 2670 TP | MA |
NPI | 1043205834 |
---|---|
Provider Name | Dr. Arnold Steven Zide |
First Address | Southborough, MA 01772-1035 |
Second Address | Boston, MA 02110 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2005 |
Last Update Date | 07/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0334286 | (05) | MA |
T59252 | (02) | MA |