Individual
DR. KENNETH BELLUCCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1445 MAIN ST, TEWKSBURY, MA 01876-4723
(978) 851-3818
Mailing address
1445 MAIN ST, TEWKSBURY, MA 01876-4723
(978) 851-3818
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2886
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03119
SPECTERA
MA
05
—
0341584
—
MA
01
—
152049
HARVARD HEALTH CARE
MA
01
—
34922
DAVIS VISION
MA
01
—
705042
TUFTS HEALTH CARE
MA
01
—
W15536
BLUE CROSS/BLUE SCHIELD
MA
Enumeration date
09/14/2006
Last updated
07/08/2007
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