Provider Demographics
NPI:1275623944
Name:GERBLICH, JUDITH CHASSIS (MD)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:CHASSIS
Last Name:GERBLICH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 201987
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120-8116
Mailing Address - Country:US
Mailing Address - Phone:440-717-1113
Mailing Address - Fax:216-921-8891
Practice Address - Street 1:1422 EUCLID AVE
Practice Address - Street 2:616
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44115-1902
Practice Address - Country:US
Practice Address - Phone:216-771-6565
Practice Address - Fax:216-921-8891
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35041172207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHA80067Medicare UPIN