Provider Demographics
NPI:1326310970
Name:METZ, JAMES GERARD (OPT, PHD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:GERARD
Last Name:METZ
Suffix:
Gender:M
Credentials:OPT, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 FOX HUNT LN
Mailing Address - Street 2:
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-1110
Mailing Address - Country:US
Mailing Address - Phone:631-751-5488
Mailing Address - Fax:
Practice Address - Street 1:6 FOX HUNT LN
Practice Address - Street 2:
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-1110
Practice Address - Country:US
Practice Address - Phone:631-751-5488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-28
Last Update Date:2012-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003371156FC0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FC0801XEye and Vision Services ProvidersTechnician/TechnologistContact Lens Fitter