Healthcare Provider Details

I. General information

NPI: 1871593798
Provider Name (Legal Business Name): FRANK D PUZIO O.D., F.A.A.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 01/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38 ROUTE 134
SOUTH DENNIS MA
02660-3700
US

IV. Provider business mailing address

83 THACHER SHORE RD
YARMOUTH PORT MA
02675-1127
US

V. Phone/Fax

Practice location:
  • Phone: 508-394-2211
  • Fax: 508-398-4471
Mailing address:
  • Phone: 508-362-2423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberMA 2462
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: