Provider Demographics
NPI:1366190340
Name:GDP OPTICAL INC
Entity type:Organization
Organization Name:GDP OPTICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:PROTOPAPAS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:718-777-7678
Mailing Address - Street 1:2201 31ST ST
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11105-3341
Mailing Address - Country:US
Mailing Address - Phone:718-777-7678
Mailing Address - Fax:
Practice Address - Street 1:2201 31ST ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11105-3341
Practice Address - Country:US
Practice Address - Phone:718-777-7678
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-17
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty