Provider Demographics
NPI:1821175373
Name:NEADER, ERIC E (OD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:E
Last Name:NEADER
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 1:664 ARDEN ST
Mailing Address - Street 2:
Mailing Address - City:LEWIS CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43035-8442
Mailing Address - Country:US
Mailing Address - Phone:614-785-1149
Mailing Address - Fax:614-885-8181
Practice Address - Street 1:1500 POLARIS PKWY
Practice Address - Street 2:SUITE 1234
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43240-2126
Practice Address - Country:US
Practice Address - Phone:614-885-3937
Practice Address - Fax:614-885-8181
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5499152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHV08118Medicare UPIN
OHNE4176601Medicare PIN
OHDR9359341Medicare PIN