Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 5237 | MA |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 5237 | MA |
NPI | 1285157966 |
---|---|
Provider Name | Dr. Avani Dave |
First Address | Orchard Park, NY 14127-1570 |
Second Address | Boston, MA 02215-1274 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2017 |
Last Update Date | 23/06/2021 |