Provider Demographics
NPI:1306929187
Name:CHASKELSON, GERALD (OD)
Entity type:Individual
Prefix:DR
First Name:GERALD
Middle Name:
Last Name:CHASKELSON
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 1:236 NICHOLAS DRIVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:MA
Mailing Address - Zip Code:01523
Mailing Address - Country:US
Mailing Address - Phone:978-368-1998
Mailing Address - Fax:
Practice Address - Street 1:119 NEW ATHOL RD
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:MA
Practice Address - Zip Code:01364-9603
Practice Address - Country:US
Practice Address - Phone:978-249-6308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2213152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA99754201OtherNETWORK HEALTH
MA0024336OtherNEIGHBORHOOD HEALTH PLAN
NY02298OtherDAVIS VISION
MA0302759Medicaid
MA725446OtherTUFTS HEATH PLAN
MAW15385OtherBLUE CROSS BLUE SHIELD MA
MA99754201OtherNETWORK HEALTH