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General NPI Number Information
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NPI Number | 1679673958
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Entity Type | Individual
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Provider Name | VICTORIA LEIGH DZURINKO O.D.
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Gender | Female
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 04/16/2019
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Provider Practice Location Address
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Address Line | 1710 CLEMENTS BRIDGE RD
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City | DEPTFORD
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State | NJ
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Zip | 08096-2010
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Country | US
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Telephone | 856-537-7214
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Fax | 856-579-4354
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Provider Business Mailing Address
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Address Line | PO BOX 5401
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City | DEPTFORD
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State | NJ
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Zip | 08096-0401
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Country | US
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Telephone | 412-994-0506
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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 | OM00132800
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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 | NH0786
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License Number State | NH
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4666
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License Number State | MA
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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 | OE000344G
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License Number State | PA
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Taxonomy #5
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | I3-0001407
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License Number State | DE
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Taxonomy #6
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OA000658900
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License Number State | NJ
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