Patricia Ann Domenichello, OPTICIAN
Individual provider Active NPI Optician · Moultonborough, NH
NPI 1669060950 · NPPES record last updated Jan 4, 2021
Key facts
- NPI
- 1669060950
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optician 156FX1800X
- License
- 2527 (NH)
- Practice address
- 517 Whittier Hwy
Moultonborough, NH 03254-3213 - Phone
- (603) 493-1462
- NPI assigned
- Jan 4, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
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 |
|---|---|---|---|
| 2527 | NH | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Four Your Eyes Only LLC | Optician | Current |
Accepting new patients |
Locations
517 Whittier Hwy
Moultonborough, NH 03254
Phone (603) 253-5484
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 2527 | NH | Yes |
Addresses
Primary practice location
517 Whittier Hwy
Moultonborough, NH 03254-3213
Mailing address
517 Whittier Hwy
Moultonborough, NH 03254-3213
Phone (603) 493-1462
Other providers in Moultonborough, NH
- Jennifer Jean Burke
- April Womack Chambers
- Justin Clark
- Allyson Coggins
- Hilary Diehl
- Kristen Fecteau
- Jill Heather Flanagan
- Four Your Eyes Only LLC
- Julie Elizabeth Furlan
- Jennifer Goodale Galea
All providers in Moultonborough, NH · Optician in New Hampshire
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 4, 2021. 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.