Provider Demographics
NPI:1700212982
Name:GUILMARTIN, GREGORY P (LICENSED OPTICIAN)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:P
Last Name:GUILMARTIN
Suffix:
Gender:M
Credentials:LICENSED OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2989-1 SHELBURNE RD.
Mailing Address - Street 2:
Mailing Address - City:SHELBURNE
Mailing Address - State:VT
Mailing Address - Zip Code:05482
Mailing Address - Country:US
Mailing Address - Phone:802-985-8333
Mailing Address - Fax:802-985-5770
Practice Address - Street 1:2989 SHELBURNE ROAD
Practice Address - Street 2:
Practice Address - City:SHELBURNE
Practice Address - State:VT
Practice Address - Zip Code:05482
Practice Address - Country:US
Practice Address - Phone:802-985-8333
Practice Address - Fax:802-985-5770
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-19
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VT028.0000346156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician