Basic Information
| Provider Information | |||||||||
| NPI: | 1396285748 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZHOU | ||||||||
| FirstName: | JIAYI | ||||||||
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| Credential: | OD, PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 31 MALL RD | ||||||||
| Address2: | DEPARTMENT OF OPHTHALMOLOGY | ||||||||
| City: | BURLINGTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018034138 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7817448555 | ||||||||
| FaxNumber: | 7817442540 | ||||||||
| Practice Location | |||||||||
| Address1: | 31 MALL RD | ||||||||
| Address2: | DEPARTMENT OF OPHTHALMOLOGY | ||||||||
| City: | BURLINGTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7817448555 | ||||||||
| FaxNumber: | 7817442540 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/06/2017 | ||||||||
| LastUpdateDate: | 07/17/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 0940 | NH | N | Eye and Vision Services Providers | Optometrist | 152W00000X | 5200 | MA | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.