Provider Demographics
NPI:1023081064
Name:VOGEL, ARNOLD HARVEY (OD)
Entity type:Individual
Prefix:DR
First Name:ARNOLD
Middle Name:HARVEY
Last Name:VOGEL
Suffix:
Gender:M
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:PO BOX 61197
Mailing Address - Street 2:
Mailing Address - City:LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01106
Mailing Address - Country:US
Mailing Address - Phone:413-567-2080
Mailing Address - Fax:413-567-7962
Practice Address - Street 1:809 WILLIAMS ST
Practice Address - Street 2:
Practice Address - City:LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01106
Practice Address - Country:US
Practice Address - Phone:413-567-2080
Practice Address - Fax:413-567-7962
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2206152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA17502OtherHEALTH NEW ENGLAND
MA102496OtherCIGNA
MAW15148OtherBLUE CROSS BLUE SHIELD
MA736566OtherCONNECTICARE
MA0317217Medicaid
2206OtherLICENSE NUMBER
MA736566OtherCONNECTICARE
134158Medicare ID - Type Unspecified