Healthcare Provider Details

I. General information

NPI: 1548525041
Provider Name (Legal Business Name): GELT VISION , INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2012
Last Update Date: 07/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

167 W 72ND ST
NEW YORK NY
10023-3221
US

IV. Provider business mailing address

167 W 72ND ST
NEW YORK NY
10023-3221
US

V. Phone/Fax

Practice location:
  • Phone: 212-769-1410
  • Fax: 212-362-0456
Mailing address:
  • Phone: 212-769-1410
  • Fax: 212-362-0456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number007271
License Number StateNY

VIII. Authorized Official

Name: MR. MELS MAERON
Title or Position: PRESIDENT
Credential:
Phone: 212-769-1410