Provider Demographics
NPI:1679504161
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/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:L
Authorized Official - Last Name:MORER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
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 1:101 CENTERPOINT DR STE 215
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-7568
Practice Address - Country:US
Practice Address - Phone:888-964-6681
Practice Address - Fax:888-662-0859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004124658Medicaid
CTCA5924OtherMEDICARE RAILROAD
CT50HEALTHDCT01OtherBLUE CROSS BLUE SHIELD
CT004124658Medicaid