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General NPI Number Information
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NPI Number | 1275623944
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Entity Type | Individual
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Provider Name | JUDITH CHASSIS GERBLICH MD
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Gender | Female
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1422 EUCLID AVE 616
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City | CLEVELAND
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State | OH
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Zip | 44115-1902
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Country | US
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Telephone | 216-771-6565
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Fax | 216-921-8891
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Provider Business Mailing Address
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Address Line | PO BOX 201987
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City | CLEVELAND
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State | OH
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Zip | 44120-8116
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Country | US
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Telephone | 440-717-1113
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Fax | 216-921-8891
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 35041172
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License Number State | OH
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