Provider Demographics
NPI:1104687706
Name:WRIGHT, O'NEIL CHRISTOPHER (LDO, ABOC, NCLEC)
Entity type:Individual
Prefix:MR
First Name:O'NEIL
Middle Name:CHRISTOPHER
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:LDO, ABOC, NCLEC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 SONOMA ST APT 4
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02121-2934
Mailing Address - Country:US
Mailing Address - Phone:857-209-6010
Mailing Address - Fax:
Practice Address - Street 1:24 SONOMA ST
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02121-2934
Practice Address - Country:US
Practice Address - Phone:617-352-9588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADOP6845156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician