Provider Demographics
NPI:1306889191
Name:ZAHKA, WAYNE E (OD)
Entity type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:E
Last Name:ZAHKA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:738 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02090-2503
Mailing Address - Country:US
Mailing Address - Phone:781-329-5454
Mailing Address - Fax:781-329-7813
Practice Address - Street 1:738 HIGH ST
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:MA
Practice Address - Zip Code:02090-2503
Practice Address - Country:US
Practice Address - Phone:781-329-5454
Practice Address - Fax:781-329-7813
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3168152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA03252799Medicaid
MA703958OtherTUFTS HEALTH PLAN
MAW15685OtherBLUE CROSS BLUE SHIELD
T59369Medicare UPIN
MA03252799Medicaid