Provider Demographics
NPI:1043859259
Name:GIELA GELLIS OD LLC
Entity Type:Organization
Organization Name:GIELA GELLIS OD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GIELA
Authorized Official - Middle Name:
Authorized Official - Last Name:GELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:917-667-9442
Mailing Address - Street 1:2441 BUCKHURST DR
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-1668
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6067 N RIDGE RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:OH
Practice Address - Zip Code:44057-2441
Practice Address - Country:US
Practice Address - Phone:440-417-0111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-06
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty