Basic Information
| Provider Information | |||||||||
| NPI: | 1235110941 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TOOMEY-GITTO | ||||||||
| FirstName: | CAROLINE | ||||||||
| MiddleName: | |||||||||
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| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 940 COMMONWEALTH AVENUE | ||||||||
| Address2: | SUITE 2 | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6175875511 | ||||||||
| FaxNumber: | 6175875514 | ||||||||
| Practice Location | |||||||||
| Address1: | 799 WEST BOYLSTON STREET | ||||||||
| Address2: | |||||||||
| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01606 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6175875511 | ||||||||
| FaxNumber: | 6175875514 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/09/2005 | ||||||||
| LastUpdateDate: | 03/05/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 3377 | MA | Y | Eye and Vision Services Providers | Optometrist |
ID Information
| ID | Type | State | Issuer | Description | 0353876 | 05 | MA | MEDICAID | 2855138 | 01 | MA | CIGNA | OTHER | 4667155 | 01 | MA | AETNA | OTHER | MA3377 | 01 | MA | EYEMED | OTHER | 150557 | 01 | MA | HARVARD PILGRIM | OTHER | 042621019 | 01 | CORP TAX ID | OTHER | 0353876 | 01 | MA | MASS HEALTH | OTHER |