Healthcare Provider Details

I. General information

NPI: 1235118134
Provider Name (Legal Business Name): CHRISTOPHER GENTILE O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2469 MERRICK RD
BELLMORE NY
11710-5705
US

IV. Provider business mailing address

8614 WESTWOOD CENTER DR FL 9
VIENNA VA
22182-2442
US

V. Phone/Fax

Practice location:
  • Phone: 516-785-2288
  • Fax: 516-221-2652
Mailing address:
  • Phone: 703-847-8899
  • Fax: 571-223-6780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number004665
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: