Provider Demographics
NPI:1689161846
Name:METZ, ANDREW (DISPENSING OPTICIAN)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:
Last Name:METZ
Suffix:
Gender:M
Credentials:DISPENSING OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01609-2240
Mailing Address - Country:US
Mailing Address - Phone:508-799-2511
Mailing Address - Fax:508-799-4841
Practice Address - Street 1:188 PARK AVE
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01609-2240
Practice Address - Country:US
Practice Address - Phone:508-799-2511
Practice Address - Fax:508-799-4841
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-13
Last Update Date:2018-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6144156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician