Provider Demographics
NPI:1700858875
Name:NECKERS, KAREN (OD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:NECKERS
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 1:12 ELIZABETH LN
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-2004
Mailing Address - Country:US
Mailing Address - Phone:978-535-9604
Mailing Address - Fax:978-535-9604
Practice Address - Street 1:210 ANDOVER ST
Practice Address - Street 2:MACYS LENSCRAFTERS
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960
Practice Address - Country:US
Practice Address - Phone:978-532-0216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-03
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3667152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW16213OtherBLUECROSS BLUESHIELD
MAW16213OtherBLUECROSS BLUESHIELD
MA452858Medicare ID - Type Unspecified