San Clemente, Adele M
San Clemente, Adele M is an individual health care provider with primary practice located at 823 Washington St , Braintree MA 02184. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. San Clemente, Adele M can be contacted via phone (781) 848-7977.Contact Information
Primary practice address
823 Washington St
Braintree MA 02184
Phone: (781) 848-7977
Fax: (781) 848-7977
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2660 | Massachusetts |
Profile Details
| NPI number | 1396833752 |
|---|---|
| LBN Legal business name | San Clemente, Adele M |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 11th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396833752 | NPPES |
| Other | W15298 | BX | |
| MEDICAID | 0331139 | BX |
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