Kenneth J Fazio, LDO
Technician/Technologist, Optician in South Waltham, Massachusetts
1457133308- Practice location
- 9 Hope Ave, South Waltham, MA 02453-2741
- Phone
- 781-216-1444
- Fax
- —
- Last updated
- November 1, 2023
Kenneth John Fazio is a Technician/Technologist, Optician based in South Waltham, MA. Kenneth John Fazio practices in South Waltham, MA and has the professional credentials of LDO. The NPI Number for Kenneth John Fazio is 1457133308 and holds a License No. 6391 (MA). The current practice location address for Kenneth John Fazio is 9 Hope Ave, South Waltham, MA 02453-2741 and can be reached out via phone at 781-216-1444.
Provider Profile Details
- NPI Number
- 1457133308
- Provider Name
- Kenneth John Fazio
- Credential
- LDO
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 9 Hope Ave, South Waltham, MA 02453-2741
- Phone Number
- 781-216-1444
- Primary Taxonomy
- Technician/Technologist, Optician · 156FX1800X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- October 16, 2023
- Last Update Date
- November 1, 2023
- Certification Date
- November 1, 2023
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 9 Hope Ave
South Waltham, MA 02453-2741 - City
- South Waltham
- State
- Massachusetts
- Zip
- 02453-2741
- Phone Number
- 781-216-1444
Provider Business Mailing Address Details
- Address
- 9 Hope Ave
Waltham, MA 02453-2741 - City
- Waltham
- State
- MA
- Zip
- 02453-2741
- Phone Number
- 781-216-1444
License Information
- Taxonomy (1)
- Technician/Technologist, Optician · 156FX1800X
- License Number (2)
- 6391
- License State (2)
- MA
- Taxonomy (2)
- Technician/Technologist, Optician · 156FX1800X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Technician/Technologist, Opticians near South Waltham, MA
View all Technician/Technologist, Opticians in South Waltham →Frequently Asked Questions
What is the NPI number of Kenneth J Fazio, LDO?
The NPI number of Kenneth J Fazio, LDO is 1457133308. It was assigned on October 16, 2023 and is currently active in the NPPES registry.
What is the specialty of Kenneth J Fazio, LDO?
Kenneth J Fazio, LDO is registered under the primary taxonomy Technician/Technologist, Optician (code 156FX1800X), licensed in MA under license number 6391.
Where does Kenneth J Fazio, LDO practice?
The practice location is 9 Hope Ave, South Waltham, MA 02453-2741. The office can be reached at 781-216-1444 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1457133308 directly on the NPPES registry website.