Provider Demographics
NPI:1932289261
Name:JAEGER, DONALD K (OD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:K
Last Name:JAEGER
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 1:10 DRAKE WAY
Mailing Address - Street 2:
Mailing Address - City:MORRIS PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07950-2657
Mailing Address - Country:US
Mailing Address - Phone:973-539-9865
Mailing Address - Fax:973-427-5422
Practice Address - Street 1:186 WARBURTON AVE
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:NJ
Practice Address - Zip Code:07506-2531
Practice Address - Country:US
Practice Address - Phone:973-427-4864
Practice Address - Fax:973-427-5422
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00288400152W00000X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered152W00000XEye and Vision Services ProvidersOptometrist
Not Answered152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1643002Medicaid
NJUO1554Medicare UPIN
NJ1643002Medicaid