Provider Demographics
NPI:1679069512
Name:DRIZIK EYECARE INC
Entity type:Organization
Organization Name:DRIZIK EYECARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BORIS
Authorized Official - Middle Name:
Authorized Official - Last Name:DRIZIK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:617-510-8463
Mailing Address - Street 1:24 PINECREST VLG
Mailing Address - Street 2:
Mailing Address - City:HOPKINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01748-2172
Mailing Address - Country:US
Mailing Address - Phone:617-510-8463
Mailing Address - Fax:
Practice Address - Street 1:85 CEDAR ST
Practice Address - Street 2:
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-2100
Practice Address - Country:US
Practice Address - Phone:781-279-4347
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-03
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty