1538140280 NPI number — G & G FOCUS, INC.

Table of content: (NPI 1538140280)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538140280 NPI number — G & G FOCUS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
G & G FOCUS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
PEARLE VISION CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538140280
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
355 EASTVIEW MALL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VICTOR
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14564-1017
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
585-425-4770
Provider Business Mailing Address Fax Number:
585-425-0763

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
355 EASTVIEW MALL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VICTOR
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14564-1017
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-425-4770
Provider Business Practice Location Address Fax Number:
585-425-0763
Provider Enumeration Date:
11/09/2005

Additional Information

Authorized Official

Authorized Official Last Name:
GEBHARD
Authorized Official First Name:
EUGENE
Authorized Official Middle Name:
Authorized Official Title or Position:
OPTICIAN/FRANCHISE OWNER
Authorized Official Telephone Number:
585-425-4770

Provider Taxonomy Codes

  • Taxonomy code: 156FX1800X , with the licence number:  C003974-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 18150 . This is a "DAVIS VISION" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: G0185339370 . This is a "BLUE CHOICE/EXAM" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: NY3604 . This is a "EYEMED VISION CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 100113CS . This is a "DR. HOWARD WALTER/PREF. C" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 103293CT . This is a "PREFERRED CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: PE1590207 . This is a "CLARITY VISION" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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