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General NPI Number Information
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NPI Number | 1770571580
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Entity Type | Organization
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Legal Business Name | STEVEN E. CROUCHER, O.D. & GABRIELLE NITTI, O.D.
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Dates
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Enumeration Date | 10/06/2005
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Last Update Date | 06/09/2009
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Provider Practice Location Address
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Address Line | 77 PARK ST
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City | MONTCLAIR
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State | NJ
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Zip | 07042-2962
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Country | US
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Telephone | 973-746-5665
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Fax | 973-746-0422
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Provider Business Mailing Address
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Address Line | 77 PARK ST
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City | MONTCLAIR
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State | NJ
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Zip | 07042-2962
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Country | US
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Telephone | 973-746-5665
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Fax | 973-746-0422
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Authorized Official
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Title or Position | PARTNER
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Name | DR. STEVEN E. CROUCHER
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Credential | O.D.
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Telephone | 973-746-5665
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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 | AO 04024
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License Number State | NJ
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