MEDICARE: JAY S. DUKER M.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
1	174400000X	Specialist	72229	MA
2	207WX0108X	Uveitis and Ocular Inflammatory Disease (Ophthalmology) Physician	72229	MA

Other Identifiers

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

General Provider Information

NPI Number	:	1508820838
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAY S. DUKER M.D.

Provider Business Mailing Address
First Line	:	800 WASHINGTON ST
Second Line	:	#450
City	:	BOSTON
State	:	MA
Zip	:	02111-1552
Country	:	US
Telephone Number	:	617-636-4677
Fax Number	:	617-636-4866

Provider Business Practice Location Address
First Line	:	800 WASHINGTON ST
Second Line	:	# 450
City	:	BOSTON
State	:	MA
Zip	:	02111-1552
Country	:	US
Telephone Number	:	617-636-4677
Fax Number	:	617-636-4866

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2006
Last Update Date	:	06/27/2017

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