Provider Demographics
NPI:1689864845
Name:MASS OPTOMETRIC ASSOCIATES, PLLC
Entity type:Organization
Organization Name:MASS OPTOMETRIC ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANKL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:516-815-1646
Mailing Address - Street 1:2921 ERIE BLVD E
Mailing Address - Street 2:C/O EMPIRE VISION CENTER, INC
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13224-1430
Mailing Address - Country:US
Mailing Address - Phone:315-446-3145
Mailing Address - Fax:315-445-7675
Practice Address - Street 1:1 HIGHLAND AVE
Practice Address - Street 2:#3B TOWN LINE PLAZA
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-6603
Practice Address - Country:US
Practice Address - Phone:781-321-9039
Practice Address - Fax:781-321-8611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-25
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA152W00000X
332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332H00000XSuppliersEyewear Supplier
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty