Provider Demographics
NPI:1649596743
Name:DR. JEFF STARR
Entity Type:Organization
Organization Name:DR. JEFF STARR
Other - Org Name:ALL ABOUT EYES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:COREY
Authorized Official - Last Name:STARR
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:518-371-8788
Mailing Address - Street 1:873 ROUTE 146
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-3801
Mailing Address - Country:US
Mailing Address - Phone:518-371-8788
Mailing Address - Fax:518-371-4250
Practice Address - Street 1:873 ROUTE 146
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-3801
Practice Address - Country:US
Practice Address - Phone:518-371-8788
Practice Address - Fax:518-371-4250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-14
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005573332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU52440Medicare UPIN