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General NPI Number Information
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NPI Number | 1447310743
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Entity Type | Organization
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Legal Business Name | GAIL E. CORREALE, O.D., PLLC
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Dates
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Enumeration Date | 12/10/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 630 OLD COUNTRY RD ROOSEVELT FIELD MALL
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City | GARDEN CITY
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State | NY
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Zip | 11530-3467
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Country | US
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Telephone | 516-873-0742
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Fax |
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Provider Business Mailing Address
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Address Line | 88 JENKINS ST
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City | MERRICK
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State | NY
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Zip | 11566-1714
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Country | US
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Telephone | 516-223-1902
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. GAIL E CORREALE
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Credential | O.D.
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Telephone | 516-873-0742
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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 | TUV006373
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License Number State | NY
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