Eugene Joseph Gillan
Individual provider Active NPI Optician · Henrietta, NY
NPI 1649748435 · NPPES record last updated Nov 9, 2018
Key facts
- NPI
- 1649748435
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optician 156FX1800X
- License
- C004773-1 (NY)
- Practice address
- 2824 E Henrietta Rd
Henrietta, NY 14467-9322 - Phone
- (585) 334-9190
- NPI assigned
- Nov 9, 2018
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C004773-1 | NY | MD | Optician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rush Henrietta Opticians, P.C. | Optician | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | C004773-1 | NY | Yes |
Addresses
Primary practice location
2824 E Henrietta Rd
Henrietta, NY 14467-9322
Mailing address
2824 E Henrietta Rd
Henrietta, NY 14467-9322
Phone (585) 334-9190
Other providers in Henrietta, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 9, 2018. 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.