Provider Demographics
NPI:1679514756
Name:DELPRINCIPE, DAVID A (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:DELPRINCIPE
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 1:1541 COOPER FOSTER PARK RD
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:OH
Mailing Address - Zip Code:44001-1203
Mailing Address - Country:US
Mailing Address - Phone:440-282-2020
Mailing Address - Fax:440-282-1256
Practice Address - Street 1:1541 COOPER FOSTER PARK RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:OH
Practice Address - Zip Code:44001-1203
Practice Address - Country:US
Practice Address - Phone:440-282-2020
Practice Address - Fax:440-282-1256
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4513T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1292260001OtherNATIONAL GOVERNMENT SERVICES
OH000000141513OtherANTHEM
OH341886675026OtherCARESOURCE
OH2299070Medicaid
OHU50846Medicare UPIN
OHDA0874651Medicare ID - Type Unspecified