Individual
DR. ELIZABETH PROKOS BERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
135 MAIN ST, STURBRIDGE, MA 01566-1569
(508) 347-7309
(508) 347-7451
Mailing address
1950 OLD GALLOWS RD STE 520, VIENNA, VA 22182-3970
(703) 847-8899
(571) 223-6780
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3274
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0371050
—
MA
01
—
759056
TUFTS
MA
01
—
W15758
BCBS
MA
Enumeration date
12/12/2005
Last updated
10/06/2021
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