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Individual

DR. MICHELE R. MIRANDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
421 N MAIN ST, LEEDS, MA 01053-9764
(413) 584-4040
Mailing address
421 N MAIN ST, LEEDS, MA 01053-9764
(413) 584-4040

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
002099
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
002099
CONNECTICARE
CT
05
004224721
CT
01
090002099CT02
ANTHEM BLUE CROSS
CT
01
2V2740
HEALTHNET
CT
01
4111728
AETNA
CT
01
CT2099
COLE VISION
CT
01
P2679716
OXFORD
CT
Enumeration date
06/23/2006
Last updated
05/03/2011
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