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NPI Code Detail

MEDICARE: BATH OPTOMETRIC ASSOCIATES, P.C.

MEDICARE: BATH OPTOMETRIC ASSOCIATES, P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist571TME

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1M52290OTHERMECIGNA
2000468OTHERMEANTHEM
31041908OTHERMEAETNA
4MNT 267OTHERMEHARVARD PILGRIM
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700068137
Entity Type Code : Organization
Provider Name (Legal Business Name) : BATH OPTOMETRIC ASSOCIATES, P.C.
Provider Business Mailing Address
First Line : 126 FRONT ST
Second Line :
City : BATH
State : ME
Zip : 04530-2607
Country : US
Telephone Number : 207-443-5012
Fax Number : 207-442-8661
Provider Business Practice Location Address
First Line : 126 FRONT ST
Second Line :
City : BATH
State : ME
Zip : 04530-2607
Country : US
Telephone Number : 207-443-5012
Fax Number : 207-442-8661
Authorized Official
Title or Position : PRESIDENT/OWNER
Name : DR. LOUIS FRANCIS RICCIARDONE JR.
Credential : O.D.
Telephone Number : 207-443-5012
Provider Enumeration Date : 11/27/2007
Last Update Date : 08/02/2010

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