Provider Demographics
NPI:1205886314
Name:GAMSS, BENJAMIN PAUL (OD)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:PAUL
Last Name:GAMSS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 E 14TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-6609
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1316 KINGS HWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1904
Practice Address - Country:US
Practice Address - Phone:718-692-1980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV003548-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYVUT003548OtherHIP
NY000182604OtherAMERICHOICE
NY812385OtherAETNA
NY00491832Medicaid
NY283060101OtherHEALTH PLUS
NY2C5969OtherGUARDIAN HEALTH NET
NY0091361OtherGHI
NY906544OtherBLOCK VISION
NYP857739OtherOXFORD HEALTH PLANS
NY0091361OtherGHI
NY283060101OtherHEALTH PLUS