Provider Demographics
NPI:1073615860
Name:ANDREWS, SHAWNA RAE (DOCTOR OF OPTOMETRY)
Entity Type:Individual
Prefix:DR
First Name:SHAWNA
Middle Name:RAE
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:DOCTOR OF OPTOMETRY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 GILBERTVILLE RD
Mailing Address - Street 2:
Mailing Address - City:NEW BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:01531-1510
Mailing Address - Country:US
Mailing Address - Phone:413-593-6965
Mailing Address - Fax:413-593-6804
Practice Address - Street 1:591 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01020-5024
Practice Address - Country:US
Practice Address - Phone:413-593-6965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3726152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist