Provider Demographics
NPI:1659494151
Name:REYELL, GAIL ANN (OPTICIAN)
Entity Type:Individual
Prefix:MS
First Name:GAIL
Middle Name:ANN
Last Name:REYELL
Suffix:
Gender:F
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 PEASLEEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SCHUYLER FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12985-1921
Mailing Address - Country:US
Mailing Address - Phone:518-643-0954
Mailing Address - Fax:
Practice Address - Street 1:450 MARGARET ST
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-1755
Practice Address - Country:US
Practice Address - Phone:518-566-2020
Practice Address - Fax:518-561-5390
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY8171156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician