Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 152W00000X | Optometrist | 2057 | MA |
Y | 152W00000X | Optometrist | MA2057 | MA |
NPI | 1003875204 |
---|---|
Provider Name | Dr. Earl H Lizotte JR. |
First Address | Easthampton, MA 01027 |
Second Address | Easthampton, MA 01027 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2006 |
Last Update Date | 14/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000024532 | BMC HEALTH NET PLAN (01) | MA |
00000314701 | UNITED HEALTH CARE (01) | |
0309702 | (05) | MA |
042349836 | CIGNA HEALTH CARE (01) | |
18888 | SPECTERA (01) | |
7262815004 | CIGNA HEALTH CARE (01) | |
782883 | CONNECTICARE (01) | |
799324 | TUFTS HEALTH PLAN (01) | |
967179 | NETWORK HEALTH (01) | MA |
T59011 | (02) | |
T59011 | (02) | MA |
W15085 | BLUE CROSS BLUE SHIELD (01) | MA |