| Richard Joseph Provenzano, MD | |
|
322 Dewey St, Bennington, VT 05201-2225 | |
| (802) 447-8700 | |
| (802) 447-1500 |
| Full Name | Richard Joseph Provenzano |
|---|---|
| Gender | Male |
| Speciality | Ophthalmology |
| Location | 322 Dewey St, Bennington, Vermont |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962456905 | NPI | - | NPPES |
| I19054 | Other | VT | MABS |
| 00461192 | Medicaid | NY | |
| VT5144 | Other | VT | VTBS |
| 000000024109 | Other | MA | BMC |
| 10001651 | Other | VT | CDPHP |
| 15622 | Other | VT | 15622 |
| 15622 | Other | MA | HNE |
| 17155 | Other | VT | MVP |
| 000000024110 | Other | VT | BMC |
| 110000678A | Medicaid | MA | |
| 10001651 | Other | MA | CDPHP |
| I19054 | Other | MA | MABS |
| 0005144 | Medicaid | VT | |
| 17155 | Other | MA | MVP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207W00000X | Ophthalmology | 45884 (Massachusetts) | Secondary |
| 207W00000X | Ophthalmology | 042-0006501 (Vermont) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Richard Joseph Provenzano, MD 322 Dewey St, Bennington, VT 05201-2225 Ph: (802) 447-8700 | Richard Joseph Provenzano, MD 322 Dewey St, Bennington, VT 05201-2225 Ph: (802) 447-8700 |
Erik William Niemi, D.O. Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 322 Dewey St, Bennington, VT 05201 Phone: 802-447-8700 Fax: 802-447-1500 | |
Stuart Michael Duboff, M.D. Ophthalmology Medicare: Not Enrolled in Medicare Practice Location: 322 Dewey St, Bennington, VT 05201 Phone: 802-447-8700 Fax: 802-447-1500 | |
Dr. John Joseph Lapenta, MD Ophthalmology Medicare: Not Enrolled in Medicare Practice Location: 322 Dewey St, Bennington, VT 05201 Phone: 802-447-8700 Fax: 802-447-1500 |