Provider Demographics
NPI:1467793356
Name:CHENIER, BETH (OD)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:
Last Name:CHENIER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:BETHANY
Other - Middle Name:
Other - Last Name:BLAIR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:140 E MAIN ST
Mailing Address - Street 2:TED BUKOWSKI OD AND ASSOCIATES
Mailing Address - City:NORTON
Mailing Address - State:MA
Mailing Address - Zip Code:02766-2342
Mailing Address - Country:US
Mailing Address - Phone:508-285-2015
Mailing Address - Fax:
Practice Address - Street 1:140 E MAIN ST
Practice Address - Street 2:TED BUKOWSKI OD AND ASSOCIATES
Practice Address - City:NORTON
Practice Address - State:MA
Practice Address - Zip Code:02766-2342
Practice Address - Country:US
Practice Address - Phone:508-285-2015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-03
Last Update Date:2013-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI00455152W00000X
MA4015152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U52907Medicare UPIN
410000675Medicare PIN