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General NPI Number Information
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NPI Number | 1760559504
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Entity Type | Organization
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Legal Business Name | DR TED F BUKOWSKI & ASSOC PC
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 08/28/2008
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Provider Practice Location Address
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Address Line | 140 EAST MAIN ST
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City | NORTON
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State | MA
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Zip | 02766
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Country | US
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Telephone | 508-285-2015
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Fax | 508-285-5094
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Provider Business Mailing Address
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Address Line | 140 EAST MAIN ST
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City | NORTON
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State | MA
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Zip | 02766
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Country | US
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Telephone | 508-285-2015
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Fax | 508-285-5094
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Authorized Official
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Title or Position | DOCTOR
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Name | MR. TED F BUKOWSKI
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Credential | OD
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Telephone | 508-285-2015
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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 | OP3840
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License Number State | MA
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