Basic Information
| Provider Information | |||||||||
| NPI: | 1780650564 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BERGSCHNEIDER | ||||||||
| FirstName: | CATHERINE | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | O.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ALLARD | ||||||||
| OtherFirstName: | CATHERINE | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | O.D. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 15 CENTRAL ST | ||||||||
| Address2: | |||||||||
| City: | ANDOVER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018103708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9784755252 | ||||||||
| FaxNumber: | 9784752226 | ||||||||
| Practice Location | |||||||||
| Address1: | 15 CENTRAL ST | ||||||||
| Address2: | |||||||||
| City: | ANDOVER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018103708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9784755252 | ||||||||
| FaxNumber: | 9784752226 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/23/2006 | ||||||||
| LastUpdateDate: | 07/28/2010 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| AuthorizedOfficialNameSuffix: | |||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 4287 | MA | Y | Eye and Vision Services Providers | Optometrist |
ID Information
| ID | Type | State | Issuer | Description | 610461 | 01 | VISION CARE PLAN | OTHER | W16309 | 01 | MA | BLUECROSSBLUESHIELD | OTHER | 274990 | 01 | MA | CIGNA | OTHER | 153229 | 01 | MA | HARVARD PILGRIM | OTHER | 461355 | 01 | MA | TUFTS HEALTH PLAN | OTHER | 610461 | 01 | MA | COMPBENEFITS | OTHER |