Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. DEREK GORDILLO
ActiveMR. DEREK GORDILLO is a Optician, Dispensing healthcare provider located in RICHLAND, New Jersey. NPI 1972326064 is currently active in the NPPES registry. Verify at CMS.
Optician, Dispensing · RICHLAND, NJ
Registration Details
- NPI Number
- 1972326064
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Nov 6, 2024 (1.7797564555235 yrs)
- Last Updated
- Nov 6, 2024
- License
-
31TD00386800 (NJ)
Practice Information
- Address
-
322 LLEWELLYN AVE.RICHLAND, NJ, 08350Browse NJ providers · Browse ZIP 08350
- Phone
- 8562859698
- Fax
- 8566970128
- Primary Specialty
-
Optician, Dispensing
156FX1800X
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.