MEDICARE: GREGORY OPTOMETRICS, P.A.

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
1	152W00000X	Optometrist	OP489	DC

General Provider Information

NPI Number	:	1942483235
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREGORY OPTOMETRICS, P.A.

Provider Business Mailing Address
First Line	:	1536 BENNING RD NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20002-4516
Country	:	US
Telephone Number	:	202-388-0600
Fax Number	:	202-388-3643

Provider Business Practice Location Address
First Line	:	1536 BENNING RD NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20002-4516
Country	:	US
Telephone Number	:	202-388-0600
Fax Number	:	202-388-3643

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	DR. ROSE Y GREGORY
Credential	:	O.D.
Telephone Number	:	202-388-0600

Provider Enumeration Date	:	12/11/2007
Last Update Date	:	12/11/2007

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