Provider Demographics
NPI:1538226170
Name:PAPANDREA, JOSEPH VINCENT (OD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:VINCENT
Last Name:PAPANDREA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 HEMLOCK ST
Mailing Address - Street 2:
Mailing Address - City:PAXTON
Mailing Address - State:MA
Mailing Address - Zip Code:01612-1270
Mailing Address - Country:US
Mailing Address - Phone:508-755-9890
Mailing Address - Fax:
Practice Address - Street 1:9 SUTTON AVE
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MA
Practice Address - Zip Code:01540-1738
Practice Address - Country:US
Practice Address - Phone:508-987-2018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3074152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA721174OtherTUFTS HEALTH PLAN
MA0356174Medicaid
MA112613OtherEYEMED
MA18047OtherFALLON HEALTH PLAN
MA233130OtherCIGNA HEALTHCARE
MAPAW15735OtherBLUE CROSS BLUE SHIELD
MAT59426Medicare UPIN