Provider Demographics
NPI:1780748533
Name:GETS, DIANA (OPHTALMIC DISPENSER)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:GETS
Suffix:
Gender:F
Credentials:OPHTALMIC DISPENSER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:332 9TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-4058
Mailing Address - Country:US
Mailing Address - Phone:718-965-2545
Mailing Address - Fax:718-965-2545
Practice Address - Street 1:332 9TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-4058
Practice Address - Country:US
Practice Address - Phone:718-965-2545
Practice Address - Fax:718-965-2545
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007422-1156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02705053Medicaid