Provider Demographics
NPI:1568835460
Name:GATSBY UNLIMTED LLC
Entity Type:Organization
Organization Name:GATSBY UNLIMTED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:MANETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-439-6133
Mailing Address - Street 1:505 CHURCH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-0000
Mailing Address - Country:US
Mailing Address - Phone:347-240-1019
Mailing Address - Fax:
Practice Address - Street 1:505 CHURCH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-2409
Practice Address - Country:US
Practice Address - Phone:347-240-1019
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-02
Last Update Date:2015-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier