MEDICARE: LISA A. MARQUES O.D.

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
1	152W00000X	Optometrist	3736	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336136811
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA A. MARQUES O.D.

Provider Business Mailing Address
First Line	:	51 STATE RD
Second Line	:
City	:	N DARTMOUTH
State	:	MA
Zip	:	02747-3319
Country	:	US
Telephone Number	:	508-994-1400
Fax Number	:	508-910-2228

Provider Business Practice Location Address
First Line	:	1741 PRESIDENT AVE
Second Line	:
City	:	FALL RIVER
State	:	MA
Zip	:	02720-7113
Country	:	US
Telephone Number	:	508-674-2020
Fax Number	:	508-674-0359

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	07/13/2023

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