Basic Information
| Provider Information | |||||||||
| NPI: | 1801272174 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MORIN | ||||||||
| FirstName: | MELISSA | ||||||||
| MiddleName: | MARQUES | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | O.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | MARQUES | ||||||||
| OtherFirstName: | MELISSA | ||||||||
| OtherMiddleName: | PATRICIA | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 23 ROCKY HILL RD | ||||||||
| Address2: | |||||||||
| City: | HADLEY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010359796 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4136264971 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 22 UNIVERSITY DR | ||||||||
| Address2: | |||||||||
| City: | AMHERST | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010022243 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135499400 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2015 | ||||||||
| LastUpdateDate: | 08/10/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 5114 | MA | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.