Provider Demographics
NPI:1013391408
Name:CERIO, NICOLE FRANCES (OD)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:FRANCES
Last Name:CERIO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:NICOLE
Other - Middle Name:FRANCES
Other - Last Name:HORN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:335 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01610-1000
Mailing Address - Country:US
Mailing Address - Phone:508-754-8872
Mailing Address - Fax:
Practice Address - Street 1:335 PARK AVE
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01610-1000
Practice Address - Country:US
Practice Address - Phone:508-754-8872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-15
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5105152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist