Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. MICHAEL PASQUALE DERENZO, LDO
Active Sole ProprietorMR. MICHAEL PASQUALE DERENZO, LDO is a Optician, Dispensing healthcare provider located in BLACKWOOD, New Jersey. NPI 1114678646 is currently active in the NPPES registry. Verify at CMS.
Optician, Dispensing · BLACKWOOD, NJ
Registration Details
- NPI Number
- 1114678646
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 17, 2022 (4.5302398339301 yrs)
- Last Updated
- Jan 17, 2022
- License
-
006765 (NY)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1 HARMON DRBLACKWOOD, NJ, 080125103Browse NJ providers · Browse ZIP 08012
- Phone
- 8562281000
- Primary Specialty
-
Optician, Dispensing
156FX1800X
Other Optician, Dispensing Providers in BLACKWOOD, NJ
| Name | Credential | NPI |
|---|---|---|
| MRS. CYNTHIA DUPRE | — | 1336890706 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.