Provider Demographics
NPI:1669457933
Name:ORELOWITZ, ILANA (OD)
Entity Type:Individual
Prefix:DR
First Name:ILANA
Middle Name:
Last Name:ORELOWITZ
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:MEDFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02052-2308
Mailing Address - Country:US
Mailing Address - Phone:508-359-9969
Mailing Address - Fax:508-359-4255
Practice Address - Street 1:55 NORTH ST
Practice Address - Street 2:
Practice Address - City:MEDFIELD
Practice Address - State:MA
Practice Address - Zip Code:02052-2308
Practice Address - Country:US
Practice Address - Phone:508-359-9969
Practice Address - Fax:508-359-4255
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4221152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AA6001OtherHARVARD PILGRIM
2201223OtherUNITED HEALTH
67835OtherFALLON
ORW16327OtherBCBS
404940OtherTUFTS
6242662002OtherCIGNA
3368255OtherAETNA
2201223OtherUNITED HEALTH
ORW17608Medicare ID - Type Unspecified
AA6001OtherHARVARD PILGRIM
404940OtherTUFTS