Provider Demographics
NPI:1083822696
Name:JOHNSON, CATHERINE ANNE (OD)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:ANNE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 COMMONWEALTH AVE SUITE
Mailing Address - Street 2:NEW ENGLAND EYE INSTITUTE
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215
Mailing Address - Country:US
Mailing Address - Phone:617-587-5511
Mailing Address - Fax:617-587-5512
Practice Address - Street 1:505 W HOLLIS ST STE 109
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062-1386
Practice Address - Country:US
Practice Address - Phone:603-882-0311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1098152WP0200X
MA4575152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA5068093OtherAETNA
MAMA4575OtherEYEMED
MA0044301OtherNHP
MA95823001OtherNETWORK HEALTH
MA0712906Medicaid
MA9679519OtherCIGNA
MAAA89356OtherHARVARD PILGRIM
311101Medicare PIN