Provider Demographics
NPI:1730214552
Name:DR SHELDON STRAUSS
Entity type:Organization
Organization Name:DR SHELDON STRAUSS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHELDON
Authorized Official - Middle Name:
Authorized Official - Last Name:STRAUSS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:617-471-2300
Mailing Address - Street 1:675 HANCOCK ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02170-2826
Mailing Address - Country:US
Mailing Address - Phone:617-471-2300
Mailing Address - Fax:617-471-0722
Practice Address - Street 1:675 HANCOCK ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02170-2826
Practice Address - Country:US
Practice Address - Phone:617-471-2300
Practice Address - Fax:617-471-0722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2085152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0035006OtherNHP
MA620980OtherTUFTS
MAW20389OtherBCBS