Bettencourt, Deborah Elaine

Bettencourt, Deborah Elaine is an sole proprietor health care provider with primary practice located at 360 W Boylston St , West Boylston MA 01583-2365. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Bettencourt, Deborah Elaine can be contacted via phone (508) 854-0595.

Contact Information

Primary practice address
360 W Boylston St West Boylston MA 01583-2365
Phone: (508) 854-0595
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 3219 Massachusetts

Profile Details

NPI number 1114023157
LBN Legal business name Bettencourt, Deborah Elaine
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 16th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114023157 NPPES
Massachusetts Other 151339 HARVARD-PILGRIM
Massachusetts MEDICAID 0354252 HARVARD-PILGRIM
Massachusetts Other 759099 HARVARD-PILGRIM
Massachusetts Other W15884 HARVARD-PILGRIM

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