Provider Demographics
NPI:1679673958
Name:DZURINKO, VICTORIA LEIGH (OD)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:LEIGH
Last Name:DZURINKO
Suffix:
Gender:F
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:PO BOX 5401
Mailing Address - Street 2:
Mailing Address - City:DEPTFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-0401
Mailing Address - Country:US
Mailing Address - Phone:412-994-0506
Mailing Address - Fax:
Practice Address - Street 1:1710 CLEMENTS BRIDGE RD
Practice Address - Street 2:
Practice Address - City:DEPTFORD
Practice Address - State:NJ
Practice Address - Zip Code:08096-2010
Practice Address - Country:US
Practice Address - Phone:856-537-7214
Practice Address - Fax:856-579-4354
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJOM00132800152W00000X
NHNH0786152W00000X
MA4666152W00000X
PAOE000344G152W00000X
DEI3-0001407152W00000X
NJOA000658900152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHNH0786OtherEYEMED
NHNH0786OtherEYEMED
NHU92556Medicare UPIN