Provider Demographics
NPI:1184783235
Name:VONNAHME, HANS (OD)
Entity type:Individual
Prefix:
First Name:HANS
Middle Name:
Last Name:VONNAHME
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 1:98 LOWER WESTFIELD RD
Mailing Address - Street 2:SUITE 9
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-9403
Mailing Address - Country:US
Mailing Address - Phone:413-552-3937
Mailing Address - Fax:413-552-3937
Practice Address - Street 1:98 LOWER WESTFIELD RD
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-9403
Practice Address - Country:US
Practice Address - Phone:413-552-3937
Practice Address - Fax:888-935-4545
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4202152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
00000002205OtherBMC
MAMA4204OtherEYEMED
W16447OtherBCBS
MA0334723Medicaid
MA28419OtherHEALTH NEW ENGLAND
MA7148370OtherAETNA
W16447OtherBCBS
MAW17610Medicare PIN