MEDICARE: GAIL E. CORREALE, O.D., PLLC

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	152W00000X	Optometrist	TUV006373	NY

General Provider Information

NPI Number	:	1447310743
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GAIL E. CORREALE, O.D., PLLC

Provider Business Mailing Address
First Line	:	88 JENKINS ST
Second Line	:
City	:	MERRICK
State	:	NY
Zip	:	11566-1714
Country	:	US
Telephone Number	:	516-223-1902
Fax Number	:

Provider Business Practice Location Address
First Line	:	630 OLD COUNTRY RD
Second Line	:	ROOSEVELT FIELD MALL
City	:	GARDEN CITY
State	:	NY
Zip	:	11530-3467
Country	:	US
Telephone Number	:	516-873-0742
Fax Number	:

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	DR. GAIL E CORREALE
Credential	:	O.D.
Telephone Number	:	516-873-0742

Provider Enumeration Date	:	12/10/2006
Last Update Date	:	08/22/2020

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