Gradisek, Robert F.

Gradisek, Robert F. is an sole proprietor health care provider with primary practice located at 1142 W 37Th St , Lorain OH 44052-5115. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Gradisek, Robert F. can be contacted via phone (440) 282-6669.

Contact Information

Primary practice address
1142 W 37Th St Lorain OH 44052-5115
Phone: (440) 282-6669
Fax: (440) 282-5397
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 3172 T921 Ohio

Profile Details

NPI number 1316902331
LBN Legal business name Gradisek, Robert F.
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 20th, 2006
Last updated Apr 22nd, 2008 - about 17 years 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316902331 NPPES
Ohio Other 0525712 MEDICARE PTAN
Ohio Other 4100043904 MEDICARE PTAN

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