| Dr. Jeanette Jezick Od., Llc | |
|
1663 Route 12, Gales Ferry, CT 06335-1500 | |
| (860) 464-1040 | |
| (860) 464-1044 |
| Full Name | Dr. Jeanette Jezick Od., Llc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 1663 Route 12, Gales Ferry, Connecticut |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144556192 | NPI | - | NPPES |
| 410000975 | Other | CT | MEDICARE ID TYPE UNSPECIFIED PTAN |
| 004132429 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 002353 (Connecticut) | Primary |
| Provider Name | Jeanette Jezick |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1922019918 PECOS PAC ID: 7416035654 Enrollment ID: I20080429000189 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Jeanette Jezick Od., Llc 1663 Route 12, Po Box 421, Gales Ferry, CT 06335-1500 Ph: (860) 464-1040 | Dr. Jeanette Jezick Od., Llc 1663 Route 12, Gales Ferry, CT 06335-1500 Ph: (860) 464-1040 |
Mark T Lopez Od Pc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1026 Long Cove Rd, Gales Ferry, CT 06335 Phone: 860-464-6060 Fax: 860-464-7013 | |
Mark T Lopez, O.D.P.C. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1026 Long Cove Rd, Gales Ferry, CT 06335 Phone: 860-464-6060 Fax: 860-464-7013 | |
Dr. Jeanette Jezick, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1663 Route 12, Gales Ferry, CT 06335 Phone: 860-464-1040 Fax: 860-464-1044 |