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Contact Information

KEVIN DIAZ
40 ENON ST
BEVERLY, MA01915-1168
 Phone: 978-922-5996
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optician

156FX1800X 96[5] Optician
Indicates primary specialty

NPI Profile & details for KEVIN DIAZ · (Male)

NPI Number 1164822516
Status Active
Credentials
Entity Individual
Enumeration date 09/03/2014
Last updated 09/03/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • MA License # 4263
  • MA Medicaid 156FX18004
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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