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General NPI Number Information
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NPI Number | 1467417618
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Entity Type | Organization
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Legal Business Name | H ROBERT GAETANO, O.D., INC
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Dates
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Enumeration Date | 04/19/2006
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Last Update Date | 03/16/2016
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Provider Practice Location Address
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Address Line | 3155 CANFIELD RD
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City | YOUNGSTOWN
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State | OH
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Zip | 44511-2880
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Country | US
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Telephone | 330-792-4923
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Fax |
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Provider Business Mailing Address
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Address Line | 3155 CANFIELD RD
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City | YOUNGSTOWN
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State | OH
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Zip | 44511-2880
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Country | US
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Telephone | 330-792-4923
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HENRY ROBERT GAETANO
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Credential | OD
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Telephone | 330-792-4923
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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 |
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License Number State |
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