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Individual

MR. BARRY L GELLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG001073
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0005620100004
PA
01
0739350001
DMERC
01
GE60796
BS
01
OEG001073
PA NUMBER
PA
01
P00178464
GBA RR
Enumeration date
08/25/2005
Last updated
03/07/2023
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