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NPI 1396749180

NPI 1396749180 : ANNA DIGESO O.D. : RARITAN, NJ

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General NPI Number Information
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    NPI Number           |    1396749180
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    Entity Type          |    Individual 
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    Provider Name        |    ANNA DIGESO O.D.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/09/2005
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    Last Update Date     |    02/09/2022
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Provider Practice Location Address
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    Address Line         |    575 ROUTE 28 STE 106 BUILDING 1
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    City                 |    RARITAN
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    State                |    NJ
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    Zip                  |    08869-1354
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    Country              |    US
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    Telephone            |    908-725-0144
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    Fax                  |    908-722-6785
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Provider Business Mailing Address
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    Address Line         |    575 ROUTE 28 STE 106 BUILDING 1
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    City                 |    RARITAN
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    State                |    NJ
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    Zip                  |    08869-1354
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    Country              |    US
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    Telephone            |    908-725-0144
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    Fax                  |    908-722-6785
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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        |    152WC0802X
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    Taxonomy Name        |    Corneal and Contact Management Optometrist
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    License Number       |    27OA00573100
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    License Number State |    NJ
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Taxonomy #2
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    Taxonomy Code        |    152WL0500X
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    Taxonomy Name        |    Low Vision Rehabilitation Optometrist
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    License Number       |    27OA00573100
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    License Number State |    NJ
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Taxonomy #3
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    Taxonomy Code        |    152WP0200X
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    Taxonomy Name        |    Pediatric Optometrist
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    License Number       |    27OA00573100
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    License Number State |    NJ
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Taxonomy #4
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    Taxonomy Code        |    152W00000X
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    Taxonomy Name        |    Optometrist
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    License Number       |    27OA00573100
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    License Number State |    NJ
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