Provider Demographics
NPI:1710939004
Name:MOROFF, RICHARD M (OD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:M
Last Name:MOROFF
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 SHAWOMET AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:MA
Mailing Address - Zip Code:02726-4304
Mailing Address - Country:US
Mailing Address - Phone:508-674-2383
Mailing Address - Fax:508-674-2383
Practice Address - Street 1:44 SHAWOMET AVE
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:MA
Practice Address - Zip Code:02726-4304
Practice Address - Country:US
Practice Address - Phone:508-674-2383
Practice Address - Fax:508-674-2383
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2834152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0392278Medicaid
MA0392278Medicaid
MAW15966Medicare ID - Type Unspecified