Healthcare Provider Details

I. General information

NPI: 1649104951
Provider Name (Legal Business Name): GABRIELLE BESSIE PERELMUTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 AUBURN ST
AUBURN MA
01501-2438
US

IV. Provider business mailing address

3772 EARHART DR
CARMEL IN
46074-8291
US

V. Phone/Fax

Practice location:
  • Phone: 508-832-9392
  • Fax:
Mailing address:
  • Phone: 317-266-9213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberNONE
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: