MEDICARE: DR. JAY B. GOOZE 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	207W00000X	Ophthalmology Physician	5784	NH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	449260001	OTHER		MEDICARE DURABLE EQUIP

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AA608	OTHER	NH	HARVARD PILGRIM HEALTH
2	0104194Y0NH01	OTHER	NH	ANTHEM BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	1483709	OTHER	NH	CIGNA

General Provider Information

NPI Number	:	1841293214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAY B. GOOZE M.D.

Provider Business Mailing Address
First Line	:	21 GONIC RD
Second Line	:
City	:	ROCHESTER
State	:	NH
Zip	:	03867-3926
Country	:	US
Telephone Number	:	603-332-3302
Fax Number	:	603-332-9608

Provider Business Practice Location Address
First Line	:	21 GONIC RD
Second Line	:
City	:	ROCHESTER
State	:	NH
Zip	:	03867-3926
Country	:	US
Telephone Number	:	603-332-3302
Fax Number	:	603-332-9608

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

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	01/06/2011

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