Provider Demographics
NPI:1407849987
Name:ERB, MARIBETH A (OD)
Entity Type:Individual
Prefix:DR
First Name:MARIBETH
Middle Name:A
Last Name:ERB
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 1:274 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3953
Mailing Address - Country:US
Mailing Address - Phone:413-584-6616
Mailing Address - Fax:413-584-1951
Practice Address - Street 1:274 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3953
Practice Address - Country:US
Practice Address - Phone:413-584-6616
Practice Address - Fax:413-584-1951
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3506152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW15926OtherBCBS
MA0356336Medicaid
MAW15926Medicare ID - Type Unspecified