Fanciullo, Lisa

Fanciullo, Lisa is an individual health care provider with primary practice located at 1400 Vfw Pkwy , West Roxbury MA 02132-4927. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Fanciullo, Lisa can be contacted via phone (617) 323-7700.

Contact Information

Primary practice address
1400 Vfw Pkwy West Roxbury MA 02132-4927
Phone: (617) 323-7700
Fax: (857) 203-5706
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 4532 T1262 Ohio
Eye and Vision Services Providers / Optometrist 152W00000X 3692 Massachusetts

Profile Details

NPI number 1700998671
LBN Legal business name Fanciullo, Lisa
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Popular Providers