Provider Demographics
NPI:1376659706
Name:BLISS, ALFRED JOSEPH III (OD)
Entity Type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:JOSEPH
Last Name:BLISS
Suffix:III
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 1:21 VALENTE DRIVE
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604
Mailing Address - Country:US
Mailing Address - Phone:508-753-3637
Mailing Address - Fax:
Practice Address - Street 1:390 MAIN ST
Practice Address - Street 2:STE 834 C/O EYE ASSOCIATES
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608
Practice Address - Country:US
Practice Address - Phone:508-755-6141
Practice Address - Fax:508-755-7550
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3113152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA17419OtherAVESIS
MA986421OtherNETWORK HEALTH
MA729511OtherTUFTS
MA152064OtherHARVARD PILGRIM
MAW15912OtherBCBS
MA29452OtherCOST CARE
MAW201582OtherCIGNA
MA0391905Medicaid
MA2203044OtherUNITED HEALTH CARE
MA29452OtherUNICARE
MA17419OtherAVESIS
U41150Medicare UPIN