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General NPI Number Information
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NPI Number | 1790348720
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Entity Type | Organization
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Legal Business Name | DZURINKO EYE CARE SPECIALIST, LLC
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Dates
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Enumeration Date | 04/16/2019
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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 | 856-579-4354
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Authorized Official
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Title or Position | OWNER
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Name | DR. VICTORIA L DZURINKO
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Credential | OD
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Telephone | 412-994-0506
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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 |
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License Number State |
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