Provider Demographics
NPI:1104547462
Name:ZACHARY JOST OD INC PC
Entity type:Organization
Organization Name:ZACHARY JOST OD INC PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:
Authorized Official - Last Name:JOST
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:617-936-4027
Mailing Address - Street 1:31 SAINT JAMES AVE STE 135
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-4101
Mailing Address - Country:US
Mailing Address - Phone:617-936-4027
Mailing Address - Fax:617-936-3059
Practice Address - Street 1:31 SAINT JAMES AVE STE 135
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-4101
Practice Address - Country:US
Practice Address - Phone:617-936-4027
Practice Address - Fax:617-936-3059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-06
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty