Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XL0004X | Low Vision | 2246 | MA |
NPI | 1922377530 |
---|---|
Provider Name | Mrs. Ilene Meryl Greenwald |
First Address | Sharon, MA 02067-2308 |
Second Address | Newton, MA 02459 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2011 |
Last Update Date | 27/11/2017 |