Individual provider · NPI-1

Daniel Edward Bausch, O.D.

Optometrist · Springfield, MA

NPI number1184633547
StatusActive
Last updated in NPPESAug 6, 2013

Details

NPI
1184633547
Entity type
Individual (NPI-1)
Name
Daniel Edward Bausch
Credential
O.D.
Sex
Male
Sole proprietor
Yes
Enumeration date
Aug 5, 2006
Last updated
Aug 6, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
152W00000X Optometrist2337MAYes

Practice location

289 Bridge St
Springfield, MA 01103-1409

Phone 413-734-8366 · Fax 413-739-5596

Mailing address

289 Bridge St
Springfield, MA 01103-1409

Phone 413-734-8366 · Fax 413-739-5596

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