Provider Demographics
NPI:1144280488
Name:GABEL, WAYNE KEITH (OD)
Entity type:Individual
Prefix:
First Name:WAYNE
Middle Name:KEITH
Last Name:GABEL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 SOUTH HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:OSSINING
Mailing Address - State:NY
Mailing Address - Zip Code:10562
Mailing Address - Country:US
Mailing Address - Phone:914-941-2022
Mailing Address - Fax:914-762-6614
Practice Address - Street 1:75 SOUTH HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:OSSINING
Practice Address - State:NY
Practice Address - Zip Code:10562
Practice Address - Country:US
Practice Address - Phone:914-941-2022
Practice Address - Fax:914-762-6614
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV0037421152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYT93332Medicare UPIN
T93332Medicare UPIN
NYC41681Medicare ID - Type Unspecified
A400005629Medicare PIN
NYA400005629Medicare PIN