1972618254 NPI number — DIERING AND DIPIETRO ASSOCIATES PTRS

Table of content: (NPI 1972618254)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972618254 NPI number — DIERING AND DIPIETRO ASSOCIATES PTRS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DIERING AND DIPIETRO ASSOCIATES PTRS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
FAMILY EYE ASSOCIATES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1972618254
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/02/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
900 ROUTE 168
Provider Second Line Business Mailing Address:
SUITE E5
Provider Business Mailing Address City Name:
TURNERSVILLE
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08012-3233
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-227-0720
Provider Business Mailing Address Fax Number:
856-227-8550

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
900 ROUTE 168
Provider Second Line Business Practice Location Address:
SUITEE5
Provider Business Practice Location Address City Name:
TURNERSVILLE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08012-3233
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-227-0720
Provider Business Practice Location Address Fax Number:
856-227-8550
Provider Enumeration Date:
08/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DIERING
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
W
Authorized Official Title or Position:
PARTNER
Authorized Official Telephone Number:
856-227-0720

Provider Taxonomy Codes

  • Taxonomy code: 152WV0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0238261000 . This is a "AMERIHEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 3439801 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0238261000 . This is a "IBC BCBS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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