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Individual

DR. DAVID PETER DEROSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
150 W HILLCREST DR, BLOOMSBURG, PA 17815-6710
(570) 204-6547
(570) 387-9135
Mailing address
150 W HILLCREST DR, BLOOMSBURG, PA 17815-6710
(570) 204-6547
(570) 387-9135

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG001317
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
27705
GEISINGER HEALTH PLAN #
PA
01
OEG001317
PA LICENSE NUMBER
PA
Enumeration date
08/30/2006
Last updated
03/07/2023
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