Provider Demographics
NPI:1467816645
Name:MERHAR, NOAH (OD)
Entity Type:Individual
Prefix:
First Name:NOAH
Middle Name:
Last Name:MERHAR
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 GLEN RD # 1
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-3307
Mailing Address - Country:US
Mailing Address - Phone:617-721-0740
Mailing Address - Fax:
Practice Address - Street 1:54 GLEN RD # 1
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-3307
Practice Address - Country:US
Practice Address - Phone:617-721-0740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-13
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2992152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist