Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 2292 | MA |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 2292 | MA |
NPI | 1205816709 |
---|---|
Provider Name | Dr. William Joseph Mateik |
First Address | Winchendon, MA 01475-1626 |
Second Address | Winchendon, MA 01475-1626 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2006 |
Last Update Date | 07/08/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0310379 | (05) | MA |
15655 | HARVARD PILGRIM (01) | MA |
23568 | CIGNA (01) | MA |
41238 | FALLON COMMUNITY HEALTH (01) | MA |
722509 | TUFTS (01) | MA |
T 59127 | (02) | MA |
W20137 | BLUE CROSS BLUE SHIELD (01) | MA |