Provider Demographics
NPI:1477768059
Name:JEFFREY L. MORER, OD, PC
Entity Type:Organization
Organization Name:JEFFREY L. MORER, OD, PC
Other - Org Name:HEALTHDRIVE EYE CARE GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:L
Authorized Official - Last Name:MORER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-964-6681
Mailing Address - Street 1:100 CROSSING BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-5555
Mailing Address - Country:US
Mailing Address - Phone:617-964-6681
Mailing Address - Fax:339-686-2561
Practice Address - Street 1:100 CROSSING BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-5555
Practice Address - Country:US
Practice Address - Phone:617-964-6681
Practice Address - Fax:339-686-2561
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JEFFREY L. MORER, OD, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-14
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3449152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYDO4930OtherMEDICARE RAILROAD
NY02936881Medicaid
NY02936881Medicaid