Provider Demographics
NPI:1912196858
Name:MARTIN J. BAER, O.D.,P.C.
Entity Type:Organization
Organization Name:MARTIN J. BAER, O.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:781-935-1025
Mailing Address - Street 1:65 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-6711
Mailing Address - Country:US
Mailing Address - Phone:781-935-1025
Mailing Address - Fax:781-933-6110
Practice Address - Street 1:65 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-6711
Practice Address - Country:US
Practice Address - Phone:781-935-1025
Practice Address - Fax:781-933-6110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-16
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2008152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0300713Medicaid
MAW20029OtherBLUE CROSS-BLUE SHIELD
MA717364OtherTUFTS HEALTH PLAN
MA9995557OtherCIGNA
MA0041854OtherAETNA
MA226058OtherMEDICARE