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General NPI Number Information
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NPI Number | 1386973154
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Entity Type | Organization
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Legal Business Name | ORLEN EYE CARE
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Dates
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Enumeration Date | 12/08/2009
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Last Update Date | 12/08/2009
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Provider Practice Location Address
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Address Line | 50 HOLYOKE STREET # 10366
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City | HOLYOKE
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State | MA
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Zip | 01040-2709
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Country | US
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Telephone | 413-532-2700
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Fax |
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Provider Business Mailing Address
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Address Line | 50 HOLYOKE ST # 10366
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City | HOLYOKE
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State | MA
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Zip | 01040-2709
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Country | US
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Telephone | 413-532-2700
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. JOSHUA E ORLEN
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Credential | OD
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Telephone | 413-532-2700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4776
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License Number State | MA
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