Provider Demographics
NPI:1437225117
Name:THERESA M NEMETH OD INC
Entity Type:Organization
Organization Name:THERESA M NEMETH OD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:M
Authorized Official - Last Name:NEMETH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:419-385-7575
Mailing Address - Street 1:3539 GLENDALE AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-3400
Mailing Address - Country:US
Mailing Address - Phone:419-385-7575
Mailing Address - Fax:419-385-4531
Practice Address - Street 1:3539 GLENDALE AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-3400
Practice Address - Country:US
Practice Address - Phone:419-385-7575
Practice Address - Fax:419-385-4531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0680231Medicaid
TH9266361OtherGROUP
T48641Medicare UPIN
0189340001Medicare NSC
OH0680231Medicaid