Gannon, Amanda Lee
Gannon, Amanda Lee is an individual health care provider with primary practice located at 495 Cabot St Ste 1 , Beverly MA 01915-2515. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Eye and Vision Services Providers / Optometrist. Eye and Vision Services Providers / Optometrist is her primary health care specialty. Gannon, Amanda Lee can be contacted via phone (978) 921-5000.Contact Information
Primary practice address
495 Cabot St Ste 1
Beverly MA 01915-2515
Phone: (978) 921-5000
Fax: (978) 921-5003
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Eye and Vision Services Providers / Optometrist | 152W00000X | 5477 | Massachusetts |
Profile Details
| NPI number | 1659946093 |
|---|---|
| LBN Legal business name | Gannon, Amanda Lee |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 26th, 2021 |
| Last updated | Oct 25th, 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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