Provider Demographics
NPI:1336709757
Name:BURNS, BRETT PATRICK (OD)
Entity Type:Individual
Prefix:DR
First Name:BRETT
Middle Name:PATRICK
Last Name:BURNS
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 1:200 CENTER ST STE 1
Mailing Address - Street 2:
Mailing Address - City:LUDLOW
Mailing Address - State:MA
Mailing Address - Zip Code:01056-2773
Mailing Address - Country:US
Mailing Address - Phone:413-583-3600
Mailing Address - Fax:
Practice Address - Street 1:200 CENTER ST STE 1
Practice Address - Street 2:
Practice Address - City:LUDLOW
Practice Address - State:MA
Practice Address - Zip Code:01056-2773
Practice Address - Country:US
Practice Address - Phone:413-583-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-18
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5369152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist