Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 2377 | MA |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 2377 | MA |
NPI | 1326139445 |
---|---|
Provider Name | Frederick Thomas Heller |
First Address | Wilmington, MA 01887-3088 |
Second Address | Wilmington, MA 01887 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2006 |
Last Update Date | 22/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000471-HEL | VISION SERVICE PLAN (01) | MA |
0005306 | NEIGHBORHOOD HEALTH PLAN (01) | MA |
0313661 | (05) | MA |
04-2519636 | SUPERIOR (01) | MA |
139956 | MEDEX (01) | MA |
2200427 | CIGNA (01) | MA |
22-00427 | UNITED HEALTH (01) | MA |
35792 | FALLON (01) | MD |
710401 | TUFTS (01) | MA |
71401 | TUFTS MEDICARE (01) | MA |
T59185 | (02) | MA |
W15286 | BCBS (01) | MA |