MR. MICHAEL PASQUALE DERENZO LDO NPI 1114678646

NPI Information

NPI: 1114678646
Provider Name: MR. MICHAEL PASQUALE DERENZO, LDO
Classification: Technician/Technologist - 156FX1800X
Entity Type: Individual

Specialization: Optician

Address:
1 HARMON DR
BLACKWOOD, NJ
ZIP 08012
Phone: (856) 228-1000
Get Directions

MR. Michael Pasquale Derenzo, LDO is an optician technician technologist in Blackwood, NJ. The provider is opticians help fit eyeglasses and contact lenses, following prescriptions from Ophthalmologists and Optometrists. They also help customers decide which eyeglass frame or contact lenses to buy. MR. Michael Pasquale Derenzo, LDO NPI is 1114678646. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1 HARMON DR
BLACKWOOD, NJ
ZIP 08012-103
Phone: (856) 228-1000

The enumeration date for this NPI number is 1/17/2022 and was last updated on 1/17/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	156FX1800X	Technician/Technologist	Optician	006765	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	006765	OTHER	NEW YORK	LICENSED OPTICIAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »