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NPI Code Detail

MEDICARE: DR. GINA JANET PELAEZ O.D.

MEDICARE:  DR. GINA JANET PELAEZ  O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometristOPT.0003160CO

General Provider Information

NPI Number : 1083082101
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GINA JANET PELAEZ O.D.
Provider Business Mailing Address
First Line : 373 NORTHAMPTON ST APT 102
Second Line :
City : BOSTON
State : MA
Zip : 02118-4713
Country : US
Telephone Number : 857-229-3136
Fax Number :
Provider Business Practice Location Address
First Line : 1577 C ST STE 105
Second Line : PMB 945525
City : ANCHORAGE
State : AK
Zip : 99501-5127
Country : US
Telephone Number : 857-229-3136
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2015
Last Update Date : 02/19/2026

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Directions to “ DR. GINA JANET PELAEZ O.D.” Practice Location

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