Provider Demographics
NPI:1841293214
Name:GOOZE, JAY B (MD)
Entity type:Individual
Prefix:DR
First Name:JAY
Middle Name:B
Last Name:GOOZE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 GONIC RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03867-3926
Mailing Address - Country:US
Mailing Address - Phone:603-332-3302
Mailing Address - Fax:603-332-9608
Practice Address - Street 1:21 GONIC RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03867-3926
Practice Address - Country:US
Practice Address - Phone:603-332-3302
Practice Address - Fax:603-332-9608
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-31
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH5784207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHAA608OtherHARVARD PILGRIM HEALTH
NH0104194Y0NH01OtherANTHEM BCBS
NH81184194Medicaid
NH1483709OtherCIGNA
449260001OtherMEDICARE DURABLE EQUIP
D03474Medicare UPIN
NH81184194Medicaid