D'Aversa, Gerard R
D'Aversa, Gerard R is an individual health care provider with primary practice located at 70 E Sunrise Hwy Ste 400 , Valley Stream NY 11581-1233. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. D'Aversa, Gerard R can be contacted via phone (516) 374-4199.Contact Information
Primary practice address
70 E Sunrise Hwy Ste 400
Valley Stream NY 11581-1233
Phone: (516) 374-4199
Fax: (516) 295-5303
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 008756 | New York |
Profile Details
| NPI number | 1104319219 |
|---|---|
| LBN Legal business name | D'Aversa, Gerard R |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 13th, 2018 |
| Last updated | Jul 8th, 2026 - about 3 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104319219 | NPPES |
| New York | MEDICAID | 05186530 |
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