Individual
RONALD GUSTINELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
755 E MCDOWELL RD, PHOENIX, AZ 85006-2506
(602) 271-5111
Mailing address
755 E MCDOWELL RD, PHOENIX, AZ 85006-2506
(602) 271-5111
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
00087
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
174285
—
AZ
Enumeration date
02/14/2007
Last updated
07/08/2007
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