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NPI Code Detail

MEDICARE: DR. IRENE M. ZELLER O.D.

MEDICARE: DR. IRENE M. ZELLER O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometristOEG001401PA
2152W00000XOptometrist5305OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1801863980
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. IRENE M. ZELLER O.D.
Provider Business Mailing Address
First Line : 8055 MAYFIELD RD STE 105
Second Line :
City : CHESTERLAND
State : OH
Zip : 44026-2447
Country : US
Telephone Number : 440-214-8026
Fax Number : 216-201-7963
Provider Business Practice Location Address
First Line : 5805 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44103-3715
Country : US
Telephone Number : 216-675-6630
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2006
Last Update Date : 01/13/2021

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