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General NPI Number Information
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NPI Number | 1760525513
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Entity Type | Organization
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Legal Business Name | DAVID DALESSANDRO OD PA
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 06/10/2024
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Provider Practice Location Address
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Address Line | 1029 MCBRIDE AVE
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City | WOODLAND PARK
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State | NJ
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Zip | 07424-2534
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Country | US
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Telephone | 973-890-9044
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Fax | 973-890-9054
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Provider Business Mailing Address
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Address Line | 1029 MCBRIDE AVE
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City | WOODLAND PARK
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State | NJ
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Zip | 07424-2534
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Country | US
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Telephone | 973-890-9044
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Fax | 973-890-9054
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DAVID DALESSANDRO
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Credential | OD
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Telephone | 973-890-9044
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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 | NJ5363
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License Number State | NJ
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