Provider Demographics
NPI:1790701878
Name:STIRBA, GEMMA SOLIMAN (OD)
Entity Type:Individual
Prefix:DR
First Name:GEMMA
Middle Name:SOLIMAN
Last Name:STIRBA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:25 GREEN HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:DANIELSON
Mailing Address - State:CT
Mailing Address - Zip Code:06239-3509
Mailing Address - Country:US
Mailing Address - Phone:860-779-1588
Mailing Address - Fax:860-779-1754
Practice Address - Street 1:25 GREEN HOLLOW RD
Practice Address - Street 2:
Practice Address - City:DANIELSON
Practice Address - State:CT
Practice Address - Zip Code:06239-3509
Practice Address - Country:US
Practice Address - Phone:860-779-1588
Practice Address - Fax:860-779-1754
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002686152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT410001176Medicare PIN
CTV09922Medicare UPIN