Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KENNETH JOHN FAZIO, LDO
Active Sole ProprietorKENNETH JOHN FAZIO, LDO is a Optician, Dispensing healthcare provider located in SOUTH WALTHAM, Massachusetts. NPI 1457133308 is currently active in the NPPES registry. Verify at CMS.
Optician, Dispensing · SOUTH WALTHAM, MA
Registration Details
- NPI Number
- 1457133308
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 16, 2023 (2.7878545626108 yrs)
- Last Updated
- Nov 1, 2023
- License
-
6391 (MA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
9 HOPE AVESOUTH WALTHAM, MA, 024532741Browse MA providers · Browse ZIP 02453
- Phone
- 7812161444
- Primary Specialty
-
Optician, Dispensing
156FX1800X
- Additional Specialty
- Optician, Dispensing
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.