Provider Demographics
NPI:1124017421
Name:NEFT, STUART J (OD)
Entity Type:Individual
Prefix:MR
First Name:STUART
Middle Name:J
Last Name:NEFT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 REVCO RD
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:PA
Mailing Address - Zip Code:15501-7726
Mailing Address - Country:US
Mailing Address - Phone:814-443-6508
Mailing Address - Fax:814-443-0590
Practice Address - Street 1:110 REVCO RD
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:PA
Practice Address - Zip Code:15501-7726
Practice Address - Country:US
Practice Address - Phone:814-443-6508
Practice Address - Fax:814-443-0590
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOET008955152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012178900001Medicaid
PAU10517Medicare UPIN
PA0012178900001Medicaid