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Organization

DR. DANIEL DESRIVIERES ODPC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DANIEL DESRIVIERES OD (OWNER)
(201) 306-8258
Entity
Organization

Contact information

Practice address
32 N DAY ST, ORANGE, NJ 07050-3609
(973) 676-8113
(973) 672-1937
Mailing address
32 N DAY ST, ORANGE, NJ 07050-3609
(973) 676-8113
(973) 672-1937

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
332H00000X
Eyewear Supplier
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0735108
NJ
Enumeration date
03/09/2010
Last updated
02/06/2013
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