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General NPI Number Information
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NPI Number | 1801324462
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Entity Type | Organization
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Legal Business Name | NORTHAMPTON VISION SPECIALISTS, LLC
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Dates
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Enumeration Date | 05/26/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 86 MASONIC ST
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City | NORTHAMPTON
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State | MA
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Zip | 01060-3026
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Country | US
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Telephone | 413-586-5002
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Fax |
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Provider Business Mailing Address
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Address Line | 86 MASONIC ST
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City | NORTHAMPTON
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State | MA
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Zip | 01060-3026
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Country | US
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Telephone | 413-586-5002
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF OPTOMETRY
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Name | THERESA J RUGGIERO
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Credential | OD
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Telephone | 413-586-5002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WV0400X
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Taxonomy Name | Vision Therapy Optometrist
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License Number |
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License Number State |
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