Organization
JEROME GLAZER OD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEROME I GLAZER O.D. (OWNER)
(860) 529-5429
Entity
Organization
Contact information
Practice address
67 WELLS RD, WETHERSFIELD, CT 06109-3043
(860) 529-5429
(860) 563-5202
Mailing address
67 WELLS RD, WETHERSFIELD, CT 06109-3043
(860) 529-5429
(860) 563-5202
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
722
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004023875
—
CT
01
—
00402387501
BLUE CARE FAMILY PLAN
CT
01
—
090000722CT01
ANTHEM BLUE CROSS OF CT
CT
01
—
0V0193
HEALTH NET
CT
01
—
112728
EYEMED
CT
01
—
13122
SPECTERA
CT
01
—
138028
WELLCARE OF CT
CT
01
—
1497774301
NPI
CT
01
—
17098
AVESIS
CT
01
—
773845
CONNECTICARE
CT
01
—
912918
BLOCK MEDICAIDE
CT
01
—
C3E541
EMPIRE BLUE CROSS
CT
01
—
P386567
OXFORD
CT
Enumeration date
01/10/2008
Last updated
08/17/2009
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