Provider Demographics
NPI:1639899958
Name:GOTTSCHALK, EMILY HELENA (OD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:HELENA
Last Name:GOTTSCHALK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:100 KINGS HWY S
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-5504
Mailing Address - Country:US
Mailing Address - Phone:585-922-1900
Mailing Address - Fax:585-922-1002
Practice Address - Street 1:500 KREAG RD
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-3705
Practice Address - Country:US
Practice Address - Phone:585-249-8300
Practice Address - Fax:585-249-8380
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901005651152W00000X
NY009803152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist