Provider Demographics
NPI:1710573118
Name:SIEGEL, NATASHA H (OD)
Entity Type:Individual
Prefix:DR
First Name:NATASHA
Middle Name:H
Last Name:SIEGEL
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 1:479 OLD UNION TPKE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:MA
Mailing Address - Zip Code:01523-3029
Mailing Address - Country:US
Mailing Address - Phone:978-728-5445
Mailing Address - Fax:978-728-5480
Practice Address - Street 1:479 OLD UNION TPKE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:MA
Practice Address - Zip Code:01523-3029
Practice Address - Country:US
Practice Address - Phone:978-537-3900
Practice Address - Fax:978-537-6030
Is Sole Proprietor?:No
Enumeration Date:2020-12-19
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009201152W00000X
MA5450152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist