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Contact Information

ADVANCED GLAUCOMA SPECIALISTS
20 PONDMEADOW DR
SUITE 203
READING, MA01867-3218
 Phone: 781-942-9876
 Fax: 781-942-9877
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmology

207W00000X 18 Physician/Ophthalmology
Indicates primary specialty

NPI Profile & details for ADVANCED GLAUCOMA SPECIALISTS

NPI Number 1790014900
LBN Legal business name ADVANCED GLAUCOMA SPECIALISTS
Authorized official MARK LATINA - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/17/2009
Last updated 12/17/2009 - About 16 years ago
Identifiers
MA License # 48630
MA Medicaid 977865
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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