Chris Gentile, OD
Individual provider Active NPI Optometrist · Chappaqua, NY
NPI 1013969971 · NPPES record last updated Feb 25, 2008
Key facts
- NPI
- 1013969971
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 005950 (NY)
- Practice address
- 22 S Greeley Ave
Chappaqua, NY 10514-3311 - Phone
- (914) 238-5600
- Fax
- (914) 238-5617
- NPI assigned
- May 17, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005950 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chappaqua Eyecare Optometry PC | Optometrist | Past | Accepting new patients |
| Triplevision Corp | Past | Accepting new patients | |
| Manhattan Eyeworks Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 005950 | NY | Yes |
Addresses
Primary practice location
22 S Greeley Ave
Chappaqua, NY 10514-3311
Mailing address
22 S Greeley Ave
Chappaqua, NY 10514-3311
Phone (914) 238-5600
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C563H1 | Other | NY | BLUE CROSS |
Other providers in Chappaqua, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 25, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.