Provider Demographics
NPI:1891122859
Name:SPITSEREV, ANNA (OD)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:
Last Name:SPITSEREV
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:GOKHFELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:40 DOUGLAS ST
Mailing Address - Street 2:
Mailing Address - City:UXBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01569-1883
Mailing Address - Country:US
Mailing Address - Phone:508-832-8322
Mailing Address - Fax:508-832-7662
Practice Address - Street 1:40 DOUGLAS ST
Practice Address - Street 2:
Practice Address - City:UXBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01569-1883
Practice Address - Country:US
Practice Address - Phone:508-832-8322
Practice Address - Fax:508-832-7662
Is Sole Proprietor?:No
Enumeration Date:2013-10-03
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5000152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist