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NPI Code Detail

MEDICARE: MR. DOUGLAS J DUPELL OPTICIAN

MEDICARE: MR. DOUGLAS J DUPELL OPTICIAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1237700000XHearing Instrument Specialist
2156FX1800XOpticianMA4072MA

General Provider Information

NPI Number : 1225288095
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DOUGLAS J DUPELL OPTICIAN
Provider Business Mailing Address
First Line : 218 W RIVER ST
Second Line :
City : ORANGE
State : MA
Zip : 01364-1415
Country : US
Telephone Number : 978-544-3705
Fax Number :
Provider Business Practice Location Address
First Line : 119 NEW ATHOL RD
Second Line :
City : ORANGE
State : MA
Zip : 01364-9603
Country : US
Telephone Number : 978-249-9033
Fax Number : 978-249-9020
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2008
Last Update Date : 12/10/2008

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