Micley, Bruce
Micley, Bruce is an individual health care provider with primary practice located at 495 Westgate Dr , Brockton MA 02301-1833. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Micley, Bruce can be contacted via phone (508) 583-2011.Contact Information
Primary practice address
495 Westgate Dr
Brockton MA 02301-1833
Phone: (508) 583-2011
Fax: (508) 586-5382
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 3174 | Massachusetts |
Profile Details
| NPI number | 1689775710 |
|---|---|
| LBN Legal business name | Micley, Bruce |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 25th, 2006 |
| Last updated | Mar 19th, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1689775710 | NPPES |
| Massachusetts | Other | W15693 | BLUE CROSS |
| Massachusetts | Other | 150703 | BLUE CROSS |
| Massachusetts | MEDICAID | 0353574 | BLUE CROSS |
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