Healthcare Provider Details

I. General information

NPI: 1710800065
Provider Name (Legal Business Name): JULIA MARIE JAGER OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1483 WEAVER ST
SCARSDALE NY
10583-7018
US

IV. Provider business mailing address

1483 WEAVER ST
SCARSDALE NY
10583-7018
US

V. Phone/Fax

Practice location:
  • Phone: 914-472-5932
  • Fax:
Mailing address:
  • Phone: 914-472-5932
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number0011458
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: