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General NPI Number Information
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NPI Number | 1114034774
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Entity Type | Individual
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Provider Name | GARY EPPEL O.D.
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Gender | Male
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 11/26/2007
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Provider Practice Location Address
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Address Line | 1714 AVENUE M
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City | BROOKLYN
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State | NY
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Zip | 11230-5304
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Country | US
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Telephone | 718-375-4300
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Fax |
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Provider Business Mailing Address
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Address Line | 2552 E.11 STREET 2ND FLOOR
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City | BROOKLYN
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State | NY
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Zip | 11235
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Country | US
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Telephone | 646-831-7424
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TUV006232
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License Number State | NY
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