Provider Demographics
NPI:1215009089
Name:GAMA MANAGEMENT INC.
Entity Type:Organization
Organization Name:GAMA MANAGEMENT INC.
Other - Org Name:ALFA VISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:LITOVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-496-9605
Mailing Address - Street 1:1402 SHEEPSHEAD BAY RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-3814
Mailing Address - Country:US
Mailing Address - Phone:718-934-1155
Mailing Address - Fax:
Practice Address - Street 1:1402 SHEEPSHEAD BAY RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-3813
Practice Address - Country:US
Practice Address - Phone:718-934-1155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYT006567152W00000X
NYVUT 005953152WV0400X
NY00746601156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Single Specialty
No156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02579151Medicaid
NY52823OtherDAVIS VISION PROVIDER
NY7189341155OtherVSP PROVIDER
NY919663OtherBLOCK VISION PROVIDER
NY52823OtherDAVIS VISION PROVIDER