Individual
MARVIN HERTZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1157 N MAIN ST, RANDOLPH, MA 02368-2135
(781) 963-2333
Mailing address
23 ARBORO DR, SHARON, MA 02067-2218
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2254
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000022736
BMC
—
01
—
0018029
NHP
—
05
—
0307408
—
MA
01
—
150494
HPHC
—
01
—
22-00404
UNITED
—
01
—
725512
TUFTS
—
01
—
7497849003
CIGNA
—
01
—
84787
AETNA
—
01
—
W15493
BCBS
—
Enumeration date
11/29/2006
Last updated
02/24/2009
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