Provider Demographics
NPI:1386839199
Name:GERBER, STEVEN D (OD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:D
Last Name:GERBER
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 1:110 HOPMEADOW ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WEATOGUE
Mailing Address - State:CT
Mailing Address - Zip Code:06089-9407
Mailing Address - Country:US
Mailing Address - Phone:404-384-2744
Mailing Address - Fax:
Practice Address - Street 1:110 HOPMEADOW ST
Practice Address - Street 2:SUITE 100
Practice Address - City:WEATOGUE
Practice Address - State:CT
Practice Address - Zip Code:06089-9407
Practice Address - Country:US
Practice Address - Phone:404-384-2744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-14
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002728152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist