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General NPI Number Information
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NPI Number | 1538478136
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Entity Type | Individual
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Provider Name | CHRISTINA GORMAN O.D.
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Gender | Female
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Dates
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Enumeration Date | 09/29/2010
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Last Update Date | 09/11/2021
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Provider Practice Location Address
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Address Line | 2127 CROMPOND RD
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City | CORTLANDT MANOR
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State | NY
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Zip | 10567-4329
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Country | US
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Telephone | 914-737-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 1950 OLD GALLOWS RD STE 520
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City | VIENNA
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State | VA
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Zip | 22182-3970
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Country | US
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Telephone |
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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 | TUV007558
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License Number State | NY
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