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General NPI Number Information
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NPI Number | 1093934465
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Entity Type | Individual
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Provider Name | DONALD DEAN-RUSK GUERRIER O.D
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Gender | Male
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 677 MT. PROSPECT AVE
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City | NEWARK
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State | NJ
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Zip | 07104
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Country | US
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Telephone | 973-350-8224
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Fax |
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Provider Business Mailing Address
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Address Line | 11 LINCOLN PL APT J
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City | NORTH BRUNSWICK
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State | NJ
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Zip | 08902-4034
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Country | US
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Telephone | 732-658-3382
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 27OA005529
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | VUT005719
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License Number State | NY
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