Provider Demographics
NPI:1275625352
Name:PIRRO, JOHN JOSEPH (OD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JOSEPH
Last Name:PIRRO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 CHEWS LANDING RD
Mailing Address - Street 2:KERRY LYNN OPTICIANS
Mailing Address - City:LAUREL SPRINGS
Mailing Address - State:NJ
Mailing Address - Zip Code:08021-2804
Mailing Address - Country:US
Mailing Address - Phone:856-784-4141
Mailing Address - Fax:856-784-0068
Practice Address - Street 1:1230 CHEWS LANDING RD
Practice Address - Street 2:KERRY LYNN OPTICIANS
Practice Address - City:LAUREL SPRINGS
Practice Address - State:NJ
Practice Address - Zip Code:08021-2804
Practice Address - Country:US
Practice Address - Phone:856-784-4141
Practice Address - Fax:856-784-0068
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00458100152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU11971Medicare UPIN
NJPI655066Medicare ID - Type Unspecified