BOSTON OCULAR PROSTHETICS INC NPI 1982106548

NPI Information

  • NPI: 1982106548
  • Provider Name: BOSTON OCULAR PROSTHETICS INC
  • Classification: Anaplastologist - 229N00000X
  • Entity Type: Organization
  • Address: 15 LOWELL ST
    PORTLAND, ME
    ZIP 04102
  • Phone: (800) 824-2492

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NPI Details

BOSTON OCULAR PROSTHETICS INC is an anaplastologist in Portland, ME. The provider is an anaplastologist is a professional who creates prostheses for the face and body. Patients treated include those missing anatomy due to cancer, traumatic injury, or birth differences. Generally, there are no state licensing requirements for anaplastologists. Certification specific to anaplastology is provided through the Board for Certified Clinical Anaplastology (BCCA) with a credential title of Certified Clinical Anaplastologist (CCA). BOSTON OCULAR PROSTHETICS INC NPI is 1982106548. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

15 LOWELL ST
PORTLAND, ME
ZIP 04102-726
Phone: (800) 824-2492
Fax: (877) 824-2413

The provider's authorized official is Kaylee Lizabeth Dougherty .
The authorized official title is President and has the following contact phone number (800) 824-2492.

The enumeration date for this NPI number is 2/28/2018 and was last updated on 5/6/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1156FX1700XTechnician/TechnologistOcularistNo
2229N00000XAnaplastologistYes

What is NPI?

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This page was last updated on: 11/21/2025

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