Organization
BAYSTATE EYE CARE OPTICAL SHOPPE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN T BERGER M.D. (OWNER)
(413) 783-3100
Entity
Organization
Contact information
Practice address
275 BICENTENNIAL HWY STE 101, SPRINGFIELD, MA 01118-1965
(413) 783-3100
(413) 782-7998
Mailing address
275 BICENTENNIAL HWY STE 101, SPRINGFIELD, MA 01118-1965
(413) 783-3100
(413) 782-7998
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
2068
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9786945
—
MA
01
—
Q00566
BLUE SHIELD/MEDEX
MA
Enumeration date
12/23/2005
Last updated
10/05/2022
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