Diaz, Kevin

Diaz, Kevin is an individual health care provider with primary practice located at 40 Enon St , Beverly MA 01915-1168. He recently has only one registered license in Eye and Vision Services Providers / Optician, which is considered as his primary health care specialty. Diaz, Kevin can be contacted via phone (978) 922-5996.

Contact Information

Primary practice address
40 Enon St Beverly MA 01915-1168
Phone: (978) 922-5996
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optician 156FX1800X 4263 Massachusetts

Profile Details

NPI number 1164822516
LBN Legal business name Diaz, Kevin
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 3rd, 2014
Last updated Sep 3rd, 2014 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164822516 NPPES
Massachusetts MEDICAID 156FX18004

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