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General NPI Number Information
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NPI Number | 1700050960
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Entity Type | Individual
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Provider Name | GISELLE A LANDER O.D.
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Gender | Female
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Dates
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Enumeration Date | 04/18/2008
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Last Update Date | 06/07/2016
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Provider Practice Location Address
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Address Line | 5035 MAYFIELD RD SUITE 110
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City | LYNDHURST
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State | OH
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Zip | 44124-2688
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Country | US
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Telephone | 216-291-2020
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Fax | 216-291-2057
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Provider Business Mailing Address
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Address Line | 5035 MAYFIELD RD SUITE 110
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City | LYNDHURST
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State | OH
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Zip | 44124-2688
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Country | US
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Telephone | 216-291-2020
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Fax | 216-291-2057
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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 | 3717
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License Number State | OH
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