Provider Demographics
NPI:1013962083
Name:GUERRIER, KERLYNE E (OD)
Entity Type:Individual
Prefix:
First Name:KERLYNE
Middle Name:E
Last Name:GUERRIER
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 1:31 MILBURN DR
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-2256
Mailing Address - Country:US
Mailing Address - Phone:908-431-5118
Mailing Address - Fax:908-431-5118
Practice Address - Street 1:465 ROUTE 70
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-4049
Practice Address - Country:US
Practice Address - Phone:732-262-6313
Practice Address - Fax:732-262-6313
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00602100152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ101679Medicare UPIN