Provider Demographics
NPI:1679353247
Name:ALFRED, MEREDITH LYNN (OD)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:LYNN
Last Name:ALFRED
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 TRADERS WAY APT 70305
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-1392
Mailing Address - Country:US
Mailing Address - Phone:508-243-1757
Mailing Address - Fax:
Practice Address - Street 1:535 MARKET ST
Practice Address - Street 2:
Practice Address - City:LYNNFIELD
Practice Address - State:MA
Practice Address - Zip Code:01940-4030
Practice Address - Country:US
Practice Address - Phone:216-864-6846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-02
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5672152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist