NICKOLAS R WILLETTE (NPI# 1093104861) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093104861 |
| Entity Type | Individual |
| Full Name | NICKOLAS R WILLETTE |
| Credential | ABOC, NCLC, LDO |
| Practice Address |
1502 Locust St Fall River MA 02723-2719 |
| Practice Telephone | 7742765703 |
| Practice Fax Number | 8884929389 |
| Mailing Telephone | 7742765703 |
| Mailing Fax Number | 8884929389 |
| Enumeration Date | 2015-01-16 |
| Last Update Date | 2015-01-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 156FX1800X |
Technician/Technologist Specialization: Optician |
6426 | MA | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TID | 46-1793649 | 01 |
| Street Address |
1502 LOCUST ST |
| City | FALL RIVER |
| State | MA |
| Zip Code | 02723-2719 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932745494 | Kody Harrison | Social Worker | 60 County St., Fall River, MA 02723 | 2019-11-20 |
| 1184132359 | Abbigail L Cabral | Occupational Therapy Assistant | 657 Quarry St., Fall River, MA 02723 | 2018-01-22 |
| 1265766315 | Jeremiah Edillor Juson | Dentist | 387 Quarry St - Ste 100, Health First Family Care, Inc., Fall River, MA 02723 | 2009-09-22 |
| 1073715074 | Rui M Lima | Counselor | 1402 Pleasant Street, Fall River, MA 02723 | 2007-06-01 |
| 1356559165 | Priscilla Lynn Douglas | Physical Therapist | 387 Quarry St Ste 102, Fall River, MA 02723 | 2007-05-18 |
| 1407943954 | Kool Smiles Mac, PC | Dentist | 933 Pleasant Street, Suite 102-103, Fall River, MA 02723 | 2006-10-06 |
| 1639289648 | Homecare Newengland LLC | Durable Medical Equipment & Medical Supplies | 21 Father Devalles Blvd., Suite 103, Fall River, MA 02723 | 2006-08-30 |
| 1598879215 | Vasant K Kamath | Dentist | 1141 Pleasant Street, Fall River, MA 02723 | 2006-08-18 |
| 1679130694 | Elizabeth Corbett | Behavioral Analyst | 657 Quarry St, Fall River, MA 02723 | 2019-05-24 |
| 1700066495 | Michaela A Wojcik | Physical Therapist | 387 Quarry St Ste 102, Fall River, MA 02723 | 2007-11-09 |
| Find all providers in zip 02723 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528570702 | Michael Josef Leduc | Technician/Technologist | 73 Home St Apt 1, Fall River, MA 02720-5315 | 2017-10-28 |
| 1831460500 | Starr Opticians | Technician/Technologist | 235 New Boston Rd, Fall River, MA 02720-5563 | 2012-01-26 |
| 1528236635 | Starr Opticians | Technician/Technologist | 235 New Boston Road, Fall River, MA 02720 | 2008-02-12 |
| 1073642799 | Clayton R Canedy | Technician/Technologist | 52 Rock Street, Fall River, MA 02720-3126 | 2007-03-06 |
| 1194854703 | Carlos Alberto Soares | Technician/Technologist | 1554 Pleasant St, Fall River, MA 02723-1901 | 2007-03-02 |
| 1225110042 | Howard Ralph Starr | Technician/Technologist | 235 New Boston Road Fall River Mass, Fall River, MA 02720 | 2006-10-20 |
| 1295841567 | Eye Health Vision Centers,llc | Technician/Technologist | 933 Pleasant St, Fall River, MA 02723-1000 | 2006-08-21 |
| 1972018687 | Rebecca Palana | Technician/Technologist | 235 New Boston Rd, Fall River, MA 02720-5563 | 2017-12-05 |
| 1477924009 | Wal-mart Stores East, Lp | Technician/Technologist | 638 Quequechan St, Fall River, MA 02721-4005 | 2015-10-08 |
| 1982036406 | Wal-mart Stores East, Lp | Technician/Technologist | 941 Grinnell St, Fall River, MA 02721 | 2013-08-07 |
| Find all providers in FALL RIVER | ||||
| City | FALL RIVER |
| Zip Code | 02723 |
Please comment or provide details below to improve the information on NICKOLAS R WILLETTE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.