Individual
KIRTI DAVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4414 BERGENLINE AVE, UNION CITY, NJ 07087-5004
(201) 271-1600
Mailing address
4414 BERGENLINE AVE, UNION CITY, NJ 07087-5004
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OA 05381
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6690203
—
NJ
Enumeration date
12/19/2006
Last updated
07/08/2007
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