Healthcare Provider Details

I. General information

NPI: 1215009089
Provider Name (Legal Business Name): GAMA MANAGEMENT INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 10/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1402 SHEEPSHEAD BAY RD
BROOKLYN NY
11235-3813
US

IV. Provider business mailing address

1402 SHEEPSHEAD BAY RD
BROOKLYN NY
11235-3814
US

V. Phone/Fax

Practice location:
  • Phone: 718-934-1155
  • Fax:
Mailing address:
  • Phone: 718-934-1155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberT006567
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License NumberVUT 005953
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code156FX1800X
TaxonomyOptician
License Number00746601
License Number StateNY

VIII. Authorized Official

Name: DAVID LITOVSKY
Title or Position: MANAGER
Credential:
Phone: 718-496-9605