Provider Demographics
NPI:1013953744
Name:DIMEGLIO-UNFRIED, DEBORAH (OD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:
Last Name:DIMEGLIO-UNFRIED
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 1:173 JONATHON DAYTON CT
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-7693
Mailing Address - Country:US
Mailing Address - Phone:609-203-2768
Mailing Address - Fax:609-203-2768
Practice Address - Street 1:173 JONATHON DAYTON CT
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-7693
Practice Address - Country:US
Practice Address - Phone:609-203-2768
Practice Address - Fax:609-203-2768
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-21
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00555000152W00000X, 152WC0802X
NYTUV006312-1152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ052750T64Medicare ID - Type Unspecified
NYC393G1Medicare ID - Type Unspecified
U87733Medicare UPIN
NJ052750YJCXMedicare PIN