Iandolo, Dianna Marie

Iandolo, Dianna Marie is an individual health care provider with primary practice located at 10 Gove St , East Boston MA 02128-1920. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Iandolo, Dianna Marie can be contacted via phone (617) 569-5800.

Contact Information

Primary practice address
10 Gove St East Boston MA 02128-1920
Fax: (617) 568-4780
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 4821 Massachusetts

Profile Details

NPI number 1891008298
LBN Legal business name Iandolo, Dianna Marie
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2010
Last updated Jul 13th, 2016 - about 8 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 1891008298 NPPES
Massachusetts MEDICAID 110088604A

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