Boston Laser Eye Institute- Winchester LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

BOSTON LASER EYE INSTITUTE- WINCHESTER LLC

Practice address

92 High St
Unit T31
Medford, MA 02155-3850

Phone

(781) 396-4010

Fax

(617) 734-3264

NPI assigned

Aug 22, 2016

Organization subpart

No

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

Authorized official

Name

Samir Melki

Title

Owner

Phone

(617) 566-0062

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1471824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471824000000",
    "number": "1538614367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 BEACON ST",
            "address_2": "SUITE 6W",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024465587",
            "telephone_number": "617-566-0062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 HIGH ST",
            "address_2": "UNIT T31",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021553850",
            "telephone_number": "781-396-4010",
            "fax_number": "617-734-3264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSTON LASER EYE INSTITUTE- WINCHESTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-22",
        "last_updated": "2016-08-22",
        "status": "A",
        "authorized_official_last_name": "MELKI",
        "authorized_official_first_name": "SAMIR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-566-0062"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wayne Bonkowski, DPT
• Sharon Lee Bonnellbradley, LICSW
• Borrelli Counseling LLC
• Boston Behavioral Health Associates Inc
• Boston Center for Facial Aesthetics
• Boston Laser Medford LLC
• Boston Physical Therapy & Wellness, Inc
• Boston Vision Network One - Hallmark LLC
• Amy Louise Bourkiche, MSW
• Ashley Bovarnick, COTA/L

• Ophthalmology Physician in Medford, MA
• Providers in Medford, MA by specialty
• Ophthalmology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.