Provider Demographics
NPI:1073640868
Name:GURKAYNAK, DORAY IBRAHIM (OD)
Entity Type:Individual
Prefix:DR
First Name:DORAY
Middle Name:IBRAHIM
Last Name:GURKAYNAK
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 MONTGOMERY AVE
Mailing Address - Street 2:
Mailing Address - City:HAVERFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19041-1409
Mailing Address - Country:US
Mailing Address - Phone:610-506-3114
Mailing Address - Fax:215-426-7689
Practice Address - Street 1:3400 ARAMINGO AVE
Practice Address - Street 2:PEARLE
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19134-4531
Practice Address - Country:US
Practice Address - Phone:215-425-4340
Practice Address - Fax:215-426-7689
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
PAOEG000982152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAGU408506Medicare ID - Type Unspecified