Provider Demographics
NPI:1407808694
Name:CASE, JEFFREY WILLIAM (OD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:WILLIAM
Last Name:CASE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3710 ROUTE 9 S
Mailing Address - Street 2:SUITE 1501
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-4801
Mailing Address - Country:US
Mailing Address - Phone:732-780-3000
Mailing Address - Fax:732-780-1235
Practice Address - Street 1:3710 ROUTE 9 S
Practice Address - Street 2:SUITE 1501
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-4801
Practice Address - Country:US
Practice Address - Phone:732-780-3000
Practice Address - Fax:732-780-1235
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00485100152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ617973DEEMedicare PIN
NJU17979Medicare UPIN