Provider Demographics
NPI:1033201330
Name:ILANA ORELOWITZ, O.D. INC
Entity Type:Organization
Organization Name:ILANA ORELOWITZ, O.D. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ILANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ORELOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:508-837-3790
Mailing Address - Street 1:67 WEST ST
Mailing Address - Street 2:
Mailing Address - City:MEDFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02052-1577
Mailing Address - Country:US
Mailing Address - Phone:508-837-3790
Mailing Address - Fax:508-359-4255
Practice Address - Street 1:67 WEST ST
Practice Address - Street 2:
Practice Address - City:MEDFIELD
Practice Address - State:MA
Practice Address - Zip Code:02052-1577
Practice Address - Country:US
Practice Address - Phone:508-359-9969
Practice Address - Fax:508-359-4255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4221152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
W21096OtherMEDICARE GROUP
MAW20422OtherBCBS GROUP #