Provider Demographics
NPI:1205825452
Name:CERAN, PAUL R (OD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:R
Last Name:CERAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:PAUL
Other - Middle Name:R
Other - Last Name:CERAN O.D.
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:6 COMMUNITY PL
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-5254
Mailing Address - Country:US
Mailing Address - Phone:973-538-5215
Mailing Address - Fax:973-538-2155
Practice Address - Street 1:6 COMMUNITY PL
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-5254
Practice Address - Country:US
Practice Address - Phone:973-538-5215
Practice Address - Fax:973-538-2155
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-20
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00441800152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ223054375OtherCOMMERCIAL INSURANCES
NJ160OtherNEW EYES FOR THE NEEDY
NJ0419670001Medicare NSC
NJ580002937Medicare Oscar/Certification
NJ223054375OtherCOMMERCIAL INSURANCES
NJ521489Medicare PIN