Individual
DANIEL EDWARD BAUSCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
289 BRIDGE ST, SPRINGFIELD, MA 01103-1409
(413) 734-8366
(413) 739-5596
Mailing address
289 BRIDGE ST, SPRINGFIELD, MA 01103-1409
(413) 734-8366
(413) 739-5596
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2337
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0326836
—
MA
01
—
54588
UPIN
MA
Enumeration date
08/05/2006
Last updated
08/06/2013
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