NPIMap

Organization Active NPI

Lyn Desjardins Optometry LLC

  • Optometrist
  • Gloucester, MA
National Provider Identifier
1578823829
Registry record updated May 21, 2012
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Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4853 Issued in MA
Legal business name
LYN DESJARDINS OPTOMETRY LLC
Practice address
127 Eastern Ave
Gloucester, MA 01930-1802
Phone
(978) 283-0650
Fax
(978) 281-5584
NPI assigned
May 21, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2012

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

Authorized official

Name
Lyn A Desjardins, OD
Title
Owner/Manager
Phone
(978) 283-0650

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 4853 MA Primary

Addresses

Primary practice location

127 Eastern Ave
Gloucester, MA 01930-1802

Mailing address

127 Eastern Ave
Gloucester, MA 01930-1802
Phone (978) 283-0650

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1337558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337558400000",
    "number": "1578823829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 EASTERN AVE",
            "city": "GLOUCESTER",
            "state": "MA",
            "postal_code": "019301802",
            "telephone_number": "978-283-0650",
            "fax_number": "978-281-5584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 EASTERN AVE",
            "city": "GLOUCESTER",
            "state": "MA",
            "postal_code": "019301802",
            "telephone_number": "978-283-0650",
            "fax_number": "978-281-5584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYN DESJARDINS OPTOMETRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-21",
        "last_updated": "2012-05-21",
        "status": "A",
        "authorized_official_last_name": "DESJARDINS",
        "authorized_official_first_name": "LYN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "978-283-0650",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gloucester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2012; 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.