Provider Demographics
NPI:1770857203
Name:DIGIACOMO, ROBERT VINCENT (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:VINCENT
Last Name:DIGIACOMO
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 1:55 US HIGHWAY 22 E STE D
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-3128
Mailing Address - Country:US
Mailing Address - Phone:973-376-5555
Mailing Address - Fax:908-737-9616
Practice Address - Street 1:55 US HIGHWAY 22 E STE D
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-3128
Practice Address - Country:US
Practice Address - Phone:973-376-5555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-01
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14314152W00000X
NJ27OA00652200152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist