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General NPI Number Information
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NPI Number | 1508106105
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Entity Type | Organization
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Legal Business Name | DUSZAK EYE ASSOCIATES, LLC
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Dates
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Enumeration Date | 02/20/2013
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Last Update Date | 02/20/2013
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Provider Practice Location Address
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Address Line | 1130 HIGHWAY 77
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City | BRIDGETON
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State | NJ
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Zip | 08302-5988
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Country | US
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Telephone | 856-453-2739
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Fax | 856-453-2802
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Provider Business Mailing Address
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Address Line | 1130 HIGHWAY 77
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City | BRIDGETON
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State | NJ
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Zip | 08302-5988
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Country | US
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Telephone | 856-453-2739
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Fax | 856-453-2802
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Authorized Official
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Title or Position | OPTOMETRIST, OWNER
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Name | DR. ROBERT S DUSZAK
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Credential | O.D.
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Telephone | 215-520-2329
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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 | 27OA00613700
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License Number State | NJ
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