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MARTIN B. GRESAK O.D. NPI 1215124169


NPI Information

NPI: 1215124169
Provider Name: MARTIN B. GRESAK , O.D.

Doing Business As: FAMILY VISION CLINIC

Classification: Optometrist - 152WC0802X
Entity Type: Organization

Specialization: Corneal and Contact Management

Address:
301 JEFFERSON AVE
MOUNDSVILLE, WV
ZIP 26041
Phone: (304) 845-2590
Get Directions

MARTIN B. GRESAK , O.D. is a corneal and contact management optometrist in Moundsville, WV. The provider is the professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea's ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear. MARTIN B. GRESAK , O.D. NPI is 1215124169. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Family Vision Clinic.

The provider's business location address is:

301 JEFFERSON AVE
MOUNDSVILLE, WV
ZIP 26041-639
Phone: (304) 845-2590

The provider's authorized official is Martin B Gresak .
The authorized official title is Owner and has the following contact phone number (304) 599-2828.

The enumeration date for this NPI number is 9/25/2007 and was last updated on 1/8/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1152WC0802XOptometristCorneal and Contact Management748-ODWEST VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10150739000MEDICAIDWEST VIRGINIA
2GR9190342MEDICARE PINWEST VIRGINIA
3748OTHERHEALTH PLAN
4000171370OTHERWEST VIRGINIAMTN ST BC/BS
5T32586MEDICARE UPINWEST VIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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