Provider Demographics
NPI:1992126023
Name:WINK EYECARE, INC.
Entity type:Organization
Organization Name:WINK EYECARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TALINE
Authorized Official - Middle Name:
Authorized Official - Last Name:FARRA
Authorized Official - Suffix:
Authorized Official - Credentials:OD, MSC
Authorized Official - Phone:617-823-7534
Mailing Address - Street 1:125 COOLIDGE AVE
Mailing Address - Street 2:UNIT 502
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-2871
Mailing Address - Country:US
Mailing Address - Phone:617-823-7534
Mailing Address - Fax:
Practice Address - Street 1:647 E BROADWAY
Practice Address - Street 2:
Practice Address - City:SOUTH BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02127-1503
Practice Address - Country:US
Practice Address - Phone:617-823-7534
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-16
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4097152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty