Provider Demographics
NPI:1710158209
Name:CHAPPAQUA EYECARE OPTOMETRY PC
Entity Type:Organization
Organization Name:CHAPPAQUA EYECARE OPTOMETRY PC
Other - Org Name:EYE GALLERY OF CHAPPAQUA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GENTILE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:914-238-5600
Mailing Address - Street 1:22 S GREELEY AVE
Mailing Address - Street 2:
Mailing Address - City:CHAPPAQUA
Mailing Address - State:NY
Mailing Address - Zip Code:10514-3311
Mailing Address - Country:US
Mailing Address - Phone:914-238-5600
Mailing Address - Fax:914-238-5617
Practice Address - Street 1:22 S GREELEY AVE
Practice Address - Street 2:
Practice Address - City:CHAPPAQUA
Practice Address - State:NY
Practice Address - Zip Code:10514-3311
Practice Address - Country:US
Practice Address - Phone:914-238-5600
Practice Address - Fax:914-238-5617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-12
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV005961-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty