Provider Demographics
NPI:1447227038
Name:POULIN-BELAIR, DEBRA A (OD)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:A
Last Name:POULIN-BELAIR
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 1:1057 CALEF HWY
Mailing Address - Street 2:UNIT 3
Mailing Address - City:BARRINGTON
Mailing Address - State:NH
Mailing Address - Zip Code:03825-7241
Mailing Address - Country:US
Mailing Address - Phone:603-664-8005
Mailing Address - Fax:603-664-8009
Practice Address - Street 1:748 CALEF HWY UNIT 11
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:NH
Practice Address - Zip Code:03825-3649
Practice Address - Country:US
Practice Address - Phone:603-664-8005
Practice Address - Fax:603-664-8009
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-02
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH740152W00000X
MEOPT 882152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH09Y004086NH01OtherANTHEM
NH03053280Medicaid
NH20244OtherAVESIS
ME431713700Medicaid
NH5514239OtherCIGNA
NH7949414OtherAETNA
NH204573OtherCOLE MANAGED VISION
NH16242OtherDAVIS VISION
NH9383155OtherPHCS