Gregory P. Gachowski
Individual provider Active NPI Optometrist · Tupper Lake, NY
NPI 1164501458 · NPPES record last updated Dec 27, 2017
Key facts
- NPI
- 1164501458
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- TUV003743-1 (NY)
- Practice address
- 82 Park St
Tupper Lake, NY 12986-1719 - Phone
- (518) 359-2161
- Fax
- (518) 359-2168
- NPI assigned
- Nov 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100326000016 | NY | Practitioner - Optometry | 5890821136 | Practice locations: Tupper Lake, NY |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003743 | NY | MD | Behavioral Analyst |
| TUV003743-1 | NY | MD | Optometrist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | TUV003743-1 | NY | Yes |
Addresses
Primary practice location
82 Park St
Tupper Lake, NY 12986-1719
Mailing address
PO Box 1197
Tupper Lake, NY 12986-0197
Phone (518) 359-2161
Other names
- Gregory P. Gachowski
Other providers in Tupper Lake, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 27, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.