Provider Demographics
NPI:1881692598
Name:NEWMAN-EVANS, WENDY L (OD)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:L
Last Name:NEWMAN-EVANS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1 CHASE DR
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:MA
Mailing Address - Zip Code:02067-2904
Mailing Address - Country:US
Mailing Address - Phone:617-557-8497
Mailing Address - Fax:253-663-2060
Practice Address - Street 1:1 EDWARD ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021-2303
Practice Address - Country:US
Practice Address - Phone:781-828-3533
Practice Address - Fax:782-828-2471
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3263152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0354104OtherMASS HEALTH (DIV OF MED)
755245OtherTUFTS TOTAL HEALTH PLAN
W15895OtherBLUE SHIELD-INDEMNITY
755245OtherTUFTS SECURE HORIZONS
9919OtherDAVIS VISION (UNICARE)
MH1462OtherFIRST SENIORITY
152159OtherHARVARD PILGRIM POS
152159OtherHARVARD PILGRIM PPO
2200482OtherUNITED HEALTHCARE HMO PPO
0006356OtherNEIGHBORHOOD HEALTH PLAN
152159OtherHARVARD/PILGRIM
9455613OtherHEALTHSOURCE MASSACHUSETT
27611OtherCHILDREN'S MEDICAL SEC.
755245OtherTUFTS
9455613OtherCIGNA HEALTH CARE
755245OtherTUFTS BENEFIT ADMIN.
755245OtherTUFTS COMMONWEALTH PPO
V35533Medicare UPIN
W15895OtherBLUE SHIELD-INDEMNITY
755245OtherTUFTS BENEFIT ADMIN.