Provider Demographics
NPI:1376944017
Name:MOK, JANE (OD)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:
Last Name:MOK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7310 ESQUIRE CT
Mailing Address - Street 2:SUITE 3
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-5440
Mailing Address - Country:US
Mailing Address - Phone:410-796-4555
Mailing Address - Fax:410-796-8606
Practice Address - Street 1:7310 ESQUIRE CT
Practice Address - Street 2:SUITE 3
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-5440
Practice Address - Country:US
Practice Address - Phone:410-796-4555
Practice Address - Fax:410-796-8606
Is Sole Proprietor?:No
Enumeration Date:2014-09-12
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA2399152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist