Individual
ROBERTA E GAUSAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3801 FILBERT ST, PHILADELPHIA, PA 19104-2640
(215) 662-8100
Mailing address
3801 FILBERT ST, PHILADELPHIA, PA 19104-2640
(215) 662-8100
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
MD058606L
PA
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
Primary
MD058606L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015981890002
—
PA
Enumeration date
06/26/2006
Last updated
04/11/2018
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