Provider Demographics
NPI:1023162112
Name:MULER, BETY J (OD OPTOMETRY DOCTOR)
Entity type:Individual
Prefix:DR
First Name:BETY
Middle Name:J
Last Name:MULER
Suffix:
Gender:F
Credentials:OD OPTOMETRY DOCTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 DEBORAH ROAD
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02459-2867
Mailing Address - Country:US
Mailing Address - Phone:617-527-6481
Mailing Address - Fax:617-527-0380
Practice Address - Street 1:882 WALNUT ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02459-1756
Practice Address - Country:US
Practice Address - Phone:617-731-3673
Practice Address - Fax:617-527-0380
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3639152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0024446OtherNHP
MA35513OtherDAVIS VISION
MA935424OtherEYEMED
MA11579OtherSPECTERA
MAW15894OtherBLUE CROSS BLUE SHIELD
MA0300161Medicaid
MA151546OtherHARVARDPILGRIM HEALTHPLAN
MA11579OtherSPECTERA
MA0300161Medicaid