Individual
DR. TINA RENAE PORZUKOWIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
6 TSIENNETO RD STE 101, DERRY, NH 03038-1584
(603) 434-4193
(603) 437-6804
Mailing address
6 TSIENNETO RD, STE 101, DERRY, NH 03038-1584
(603) 434-4193
(603) 437-6804
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0973
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3113899
—
NH
Enumeration date
06/20/2006
Last updated
12/17/2019
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