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NPI Code Detail

MEDICARE: JSTS PLLC

MEDICARE: JSTS PLLC
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
1152W00000XOptometrist0807NH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
16374620001OTHERMEDICARE PTAN

General Provider Information

NPI Number : 1538322359
Entity Type Code : Organization
Provider Name (Legal Business Name) : JSTS PLLC
Provider Business Mailing Address
First Line : 7 HEMLOCK RD
Second Line :
City : CLAREMONT
State : NH
Zip : 03743-2426
Country : US
Telephone Number : 603-543-0827
Fax Number : 603-543-3126
Provider Business Practice Location Address
First Line : 63 PLEASANT ST
Second Line :
City : CLAREMONT
State : NH
Zip : 03743-2605
Country : US
Telephone Number : 603-543-0827
Fax Number : 603-543-3126
Authorized Official
Title or Position : OPTOMETRIST/OWNER
Name : DR. JEFFREY A SMRKOVSKI
Credential : O.D.
Telephone Number : 603-543-3125
Provider Enumeration Date : 07/02/2008
Last Update Date : 06/21/2011

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Directions to “JSTS PLLC ” Practice Location

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