Provider Demographics
NPI:1225324023
Name:FALDOWSKI, GREGORY J (OD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:J
Last Name:FALDOWSKI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10580 N MCCARRAN BLVD
Mailing Address - Street 2:STE 115-255
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-2059
Mailing Address - Country:US
Mailing Address - Phone:775-375-8869
Mailing Address - Fax:775-996-4122
Practice Address - Street 1:10580 N MCCARRAN BLVD STE 115-255
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503
Practice Address - Country:US
Practice Address - Phone:775-375-8869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV896152W00000X
CA14157TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist