Jellenek, Gregory Paul
Jellenek, Gregory Paul is an individual health care provider with primary practice located at Bldg. 1527 , Ft. Eustis VA 23604-1618. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Jellenek, Gregory Paul can be contacted via phone (757) 887-3627.Contact Information
Primary practice address
Bldg. 1527
Ft. Eustis VA 23604-1618
Phone: (757) 887-3627
Fax: (757) 887-0403
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 0618000342 | Virginia |
Profile Details
| NPI number | 1679505226 |
|---|---|
| LBN Legal business name | Jellenek, Gregory Paul |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 6th, 2006 |
| Last updated | May 23rd, 2011 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679505226 | NPPES |
| Virginia | MEDICAID | 010045711 |
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