Provider Demographics
NPI:1386216968
Name:BEAULIER, ALLYX L (OD)
Entity Type:Individual
Prefix:
First Name:ALLYX
Middle Name:L
Last Name:BEAULIER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 CORNERSTONE SQ STE 101
Mailing Address - Street 2:
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886-1474
Mailing Address - Country:US
Mailing Address - Phone:978-692-1400
Mailing Address - Fax:
Practice Address - Street 1:5 CORNERSTONE SQ STE 101
Practice Address - Street 2:
Practice Address - City:WESTFORD
Practice Address - State:MA
Practice Address - Zip Code:01886-1474
Practice Address - Country:US
Practice Address - Phone:978-692-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-13
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5490152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist