Provider Demographics
NPI:1588117378
Name:MARIPURI, CHRISTINE (OD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:
Last Name:MARIPURI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:GRANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:360 MERRIMACK ST
Mailing Address - Street 2:BLDG #9, 1ST FLOOR
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-1740
Mailing Address - Country:US
Mailing Address - Phone:978-688-6182
Mailing Address - Fax:
Practice Address - Street 1:451 ANDOVER ST
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-5044
Practice Address - Country:US
Practice Address - Phone:978-688-6182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-27
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5154152W00000X
NH0933152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist