Healthcare Provider Details

I. General information

NPI: 1699002345
Provider Name (Legal Business Name): ANTHONY FRANK GAGGI D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2009
Last Update Date: 11/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 SAINT MARKS PL
NEW YORK NY
10003-8116
US

IV. Provider business mailing address

42 ST. MARKS PLACE
NEW YORK NY
10003
US

V. Phone/Fax

Practice location:
  • Phone: 212-533-1577
  • Fax: 347-312-7672
Mailing address:
  • Phone: 212-533-1577
  • Fax: 347-312-7672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License NumberCOO5692
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code156FC0800X
TaxonomyContact Lens Technician/Technologist
License NumberCOO5692
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code156FC0801X
TaxonomyContact Lens Fitter
License NumberCOO5692
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code156FX1100X
TaxonomyOphthalmic Technician/Technologist
License NumberCOO5692
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code156FX1202X
TaxonomyOptometric Technician
License NumberCOO5692
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: