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General NPI Number Information
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NPI Number | 1770750960
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Entity Type | Organization
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Legal Business Name | DT ENTERPRISES
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Dates
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Enumeration Date | 05/15/2008
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Last Update Date | 05/15/2008
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Provider Practice Location Address
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Address Line | 64 1/2 MARKET ST
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City | CLIFTON
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State | NJ
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Zip | 07012-2404
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Country | US
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Telephone | 973-473-1500
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Fax | 973-473-1502
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Provider Business Mailing Address
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Address Line | 64 1/2 MARKET ST
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City | CLIFTON
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State | NJ
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Zip | 07012-2404
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Country | US
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Telephone | 973-473-1500
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Fax | 973-473-1502
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Authorized Official
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Title or Position | OWNER
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Name | MR. DONALD G TRISCHETTA
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Credential | OPTICIAN
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Telephone | 973-473-1500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | D00123700
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License Number State | NJ
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