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NPI Code Detail

MEDICARE: DR. BENJAMIN GELLIS O.D.

MEDICARE:  DR. BENJAMIN  GELLIS  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
1152W00000XOptometrist5600OH

General Provider Information

NPI Number : 1588691323
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BENJAMIN GELLIS O.D.
Provider Business Mailing Address
First Line : PO BOX 880
Second Line :
City : HUDSON
State : OH
Zip : 44236-5880
Country : US
Telephone Number : 330-697-4748
Fax Number : 866-425-2239
Provider Business Practice Location Address
First Line : 691 RICHMOND RD
Second Line :
City : RICHMOND HEIGHTS
State : OH
Zip : 44143-2990
Country : US
Telephone Number : 330-697-4748
Fax Number : 866-425-2239
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2006
Last Update Date : 04/25/2012

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Directions to “ DR. BENJAMIN GELLIS O.D.” Practice Location

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