Fazio, Kenneth John

Fazio, Kenneth John is an sole proprietor health care provider with primary practice located at 9 Hope Ave , South Waltham MA 02453-2741. He recently has only one registered license in Eye and Vision Services Providers / Optician, which is considered as his primary health care specialty. Fazio, Kenneth John can be contacted via phone (781) 216-1444.

Contact Information

Primary practice address
9 Hope Ave South Waltham MA 02453-2741
Phone: (781) 216-1444
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optician 156FX1800X
Eye and Vision Services Providers / Optician 156FX1800X 6391 Massachusetts

Profile Details

NPI number 1457133308
LBN Legal business name Fazio, Kenneth John
Credentials LDO
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 16th, 2023
Last updated Nov 1st, 2023 - about 2 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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