William Henry Livingston, O.D.
Individual provider Active NPI Optometrist · Newtonville, MA
NPI 1295812394 · NPPES record last updated Nov 17, 2008
Key facts
- NPI
- 1295812394
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 2719 (MA)
- Practice address
- 336 Walnut St
Newtonville, MA 02460-1923 - Phone
- (617) 964-9666
- Fax
- (617) 964-3380
- NPI assigned
- Nov 1, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2719 | MA | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2719 | MA | Yes |
Addresses
Primary practice location
336 Walnut St
Newtonville, MA 02460-1923
Mailing address
18 Cypress St
Marblehead, MA 01945-1926
Phone (781) 639-0090
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 460314 | Other | MA | TUFTS |
| 37962 | Other | MA | DAVIS VISION |
| 0335118 | Medicaid | MA | |
| 600000009 | Other | MA | HARVARD PILGRIM |
| LIW15558 | Other | MA | BLUE CROSS BLUE SHIELD |
Other providers in Newtonville, MA
- Heidrun Jacobi
- Sarah Jordan
- Abigail Kessler
- Alexi Mercedes Latronica
- Megan Lissandrello
- Lorraine Hursey Deng, Licsw, LLC
- Laura Fuchs Lubin
- Nancy Macias-Smith
- Laura Maglio
- Alison Lisa Malkin
All providers in Newtonville, MA · Optometrist in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 17, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.