Healthcare Provider Details

I. General information

NPI: 1801695911
Provider Name (Legal Business Name): NAUSET OPTICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2025
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 WEST RD
ORLEANS MA
02653-3200
US

IV. Provider business mailing address

9 WEST RD
ORLEANS MA
02653-3200
US

V. Phone/Fax

Practice location:
  • Phone: 508-255-6394
  • Fax: 508-255-1696
Mailing address:
  • Phone: 508-255-6394
  • Fax: 508-255-1696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: DIANE P TODD
Title or Position: OWNER
Credential: OD
Phone: 508-255-6394