Provider Demographics
NPI:1629080155
Name:EUGENE B. GABIANELLI, MD & ASSOC. LLC
Entity Type:Organization
Organization Name:EUGENE B. GABIANELLI, MD & ASSOC. LLC
Other - Org Name:GA EYE PARTNERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:B
Authorized Official - Last Name:GABIANELLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-897-6810
Mailing Address - Street 1:550 PEACHTREE ST NE
Mailing Address - Street 2:SUITE 1500
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2247
Mailing Address - Country:US
Mailing Address - Phone:404-897-6810
Mailing Address - Fax:404-897-4924
Practice Address - Street 1:550 PEACHTREE ST. NE
Practice Address - Street 2:SUITE 1500
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2247
Practice Address - Country:US
Practice Address - Phone:404-897-6810
Practice Address - Fax:404-897-4924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA035629207W00000X
207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP3434Medicare Oscar/Certification
GAGRP3434Medicare ID - Type Unspecified
GA1308870001Medicare NSC