Organization Name: | MARTIN B. GRESAK , O.D. |
NPI Number: | 1215124169 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARTIN B GRESAK (OWNER) |
Mailing Address: | 301 Jefferson Ave Moundsville |
State: | WV US |
Postal Code: | 260411639 |
Phone Number: | 3048452590 |
Fax Number: | |
NPI Enumeration Date: | 09/25/2007 |
NPI Last Update Date: | 01/08/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 152WC0802X |
License Number: | 748-OD |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WV |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Optometrist |
Taxonomy Specialization: | Corneal and Contact Management |
Taxonomy Definition: | The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea |