Ashley Laico Boulos, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

27OA00661700 Issued in NJ

Practice address

1430 Main Ave
Clifton, NJ 07011-2146

Phone

(800) 530-2730

NPI assigned

Jan 26, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1453766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453766400000",
    "number": "1215394945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 MAIN AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070112146",
            "telephone_number": "800-530-2730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 MAIN AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070112146",
            "telephone_number": "800-530-2730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAICO BOULOS",
        "first_name": "ASHLEY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-26",
        "last_updated": "2016-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00661700",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003087",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lab X Health II
• Lab X Health LLC
• Margareta Labocki, LMHC, LPC
• Lissette Labol, LCSW
• Sean Louis Lager, M.D.
• Nicholas Laird
• Lakeview Medical Center, PC
• Lakeview Pediatrics
• Jeffrey Fred Lakin, MD
• Judith Lang-Knutsen, AU.D

• Optometrist in Clifton, NJ
• Providers in Clifton, NJ by specialty
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.