Provider Demographics
NPI:1396285748
Name:ZHOU, JIAYI (OD, PHD)
Entity type:Individual
Prefix:
First Name:JIAYI
Middle Name:
Last Name:ZHOU
Suffix:
Gender:M
Credentials:OD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 MALL RD
Mailing Address - Street 2:DEPARTMENT OF OPHTHALMOLOGY
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803-4138
Mailing Address - Country:US
Mailing Address - Phone:781-744-8555
Mailing Address - Fax:781-744-2540
Practice Address - Street 1:31 MALL RD
Practice Address - Street 2:DEPARTMENT OF OPHTHALMOLOGY
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803
Practice Address - Country:US
Practice Address - Phone:781-744-8555
Practice Address - Fax:781-744-2540
Is Sole Proprietor?:No
Enumeration Date:2017-03-06
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0940152W00000X
MA5200152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist