Individual
MR. DEREK GORDILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
322 LLEWELLYN AVE., RICHLAND, NJ 08350
(856) 285-9698
(856) 697-0128
Mailing address
322 LLEWELLYN AVE., RICHLAND, NJ 08350
(856) 285-9698
(856) 697-0128
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
31TD00386800
NJ
Other
Enumeration date
11/06/2024
Last updated
11/06/2024
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