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General NPI Number Information
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NPI Number | 1366331605
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Entity Type | Individual
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Provider Name | GINA DOLORIS DEFLORIA OD
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Gender | Female
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Dates
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Enumeration Date | 07/01/2025
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 936 SECOND STREET PIKE
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City | RICHBORO
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State | PA
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Zip | 18954-1527
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Country | US
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Telephone | 215-485-5384
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Fax | 215-485-5709
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Provider Business Mailing Address
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Address Line | 708 GRANGE DR
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City | YARDLEY
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State | PA
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Zip | 19067-5633
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Country | US
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Telephone | 724-454-6684
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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 | OEG004272
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License Number State | PA
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