Provider Demographics
NPI:1760559504
Name:DR TED F BUKOWSKI & ASSOC PC
Entity Type:Organization
Organization Name:DR TED F BUKOWSKI & ASSOC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TED
Authorized Official - Middle Name:F
Authorized Official - Last Name:BUKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:508-285-2015
Mailing Address - Street 1:140 EAST MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORTON
Mailing Address - State:MA
Mailing Address - Zip Code:02766
Mailing Address - Country:US
Mailing Address - Phone:508-285-2015
Mailing Address - Fax:508-285-5094
Practice Address - Street 1:140 EAST MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:MA
Practice Address - Zip Code:02766
Practice Address - Country:US
Practice Address - Phone:508-285-2015
Practice Address - Fax:508-285-5094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAOP3840152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA135655OtherMETLIFE
MA153545731OtherVISION SERVICE PLAN
MA1984094001OtherCIGNA
MA0392375Medicaid
MA814302OtherAETNA
MA152099OtherHARVARD PILGRIM
MA22420OtherCVC MANAGEMENT
MA392767001OtherHEALTH NOW NY INS MEDICAR
MA2200344OtherUNITED HEALTHCARE
MA34141OtherDAVIS VISION
MAMA3840OtherEYE MED VISION
RI76434OtherHEALTHMATE
RI409293OtherBLUECHIP OF RI
MA153545731OtherTRICARE
MAW20277OtherBLUE CROSS BLUE SHIELD OF
MA152099OtherHARVARD PILGRIM
MA392767001OtherHEALTH NOW NY INS MEDICAR