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General NPI Number Information
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NPI Number | 1427137710
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Entity Type | Individual
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Provider Name | DEREK WENTWORTH GUARINO OD
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Gender | Male
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 113 NEW ROCHESTER RD SUITE ONE
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City | DOVER
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State | NH
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Zip | 03820-8800
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Country | US
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Telephone | 603-742-0045
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 912
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City | DOVER
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State | NH
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Zip | 03821-0912
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Country | US
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Telephone | 603-742-0045
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Fax | 603-742-0047
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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 | 0706
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License Number State | NH
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