Provider Demographics
NPI:1962598730
Name:RICE, MARGARET G (OPTICIAN)
Entity type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:G
Last Name:RICE
Suffix:
Gender:F
Credentials:OPTICIAN
Other - Prefix:MR
Other - First Name:GERARD
Other - Middle Name:J
Other - Last Name:BISANTZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OPTICIAN
Mailing Address - Street 1:362 MOODY ST
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453-5204
Mailing Address - Country:US
Mailing Address - Phone:781-894-0081
Mailing Address - Fax:781-894-9361
Practice Address - Street 1:362 MOODY ST
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02453-5204
Practice Address - Country:US
Practice Address - Phone:781-894-0081
Practice Address - Fax:781-894-9361
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1859156FX1800X
MA1784156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0877260001Medicare NSC