Provider Demographics
NPI:1295774362
Name:PECHTER, JAY R (MD)
Entity type:Individual
Prefix:DR
First Name:JAY
Middle Name:R
Last Name:PECHTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1880 N CONGRESS AVE
Mailing Address - Street 2:SUITE 309
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-8671
Mailing Address - Country:US
Mailing Address - Phone:561-733-2388
Mailing Address - Fax:
Practice Address - Street 1:1880 N CONGRESS AVE
Practice Address - Street 2:SUITE 309
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-8671
Practice Address - Country:US
Practice Address - Phone:561-733-2388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL39614207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL61520Medicare ID - Type Unspecified
FLD57266Medicare UPIN