Provider Demographics
NPI:1699752253
Name:PARSLOE, GINA M (OD)
Entity type:Individual
Prefix:DR
First Name:GINA
Middle Name:M
Last Name:PARSLOE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:655 MONTAUK HWY
Mailing Address - Street 2:SUITE 29
Mailing Address - City:EAST PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-4733
Mailing Address - Country:US
Mailing Address - Phone:631-447-1300
Mailing Address - Fax:631-447-1302
Practice Address - Street 1:655 MONTAUK HWY
Practice Address - Street 2:SUITE 29
Practice Address - City:EAST PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-4733
Practice Address - Country:US
Practice Address - Phone:631-447-1300
Practice Address - Fax:631-447-1302
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-26
Last Update Date:2009-04-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYVUT003894152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6003765OtherGHI PPO
NYVUT003894OtherHIP ID#
P674690OtherOXFORD HEALTHCARE
NY3C5494OtherHEALTH NET
NY003894SOtherHEALTHCARE PARTNERS
NY01289252Medicaid
NYVUT003894OtherHIP ID#
NYC44282Medicare PIN