Provider Demographics
NPI:1871593798
Name:PUZIO, FRANK D (OD, FAAO)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:D
Last Name:PUZIO
Suffix:
Gender:M
Credentials:OD, FAAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 THACHER SHORE RD
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH PORT
Mailing Address - State:MA
Mailing Address - Zip Code:02675-1127
Mailing Address - Country:US
Mailing Address - Phone:508-362-2423
Mailing Address - Fax:
Practice Address - Street 1:38 ROUTE 134
Practice Address - Street 2:
Practice Address - City:SOUTH DENNIS
Practice Address - State:MA
Practice Address - Zip Code:02660-3700
Practice Address - Country:US
Practice Address - Phone:508-394-2211
Practice Address - Fax:508-398-4471
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA 2462152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0324329Medicaid
MA404858Medicare ID - Type Unspecified
MA0324329Medicaid