Provider Demographics
NPI:1134165392
Name:DIERING, JOHN W (OD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:W
Last Name:DIERING
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 1:900 ROUTE 168
Mailing Address - Street 2:
Mailing Address - City:TURNERSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-3233
Mailing Address - Country:US
Mailing Address - Phone:856-227-0720
Mailing Address - Fax:856-227-8550
Practice Address - Street 1:900 ROUTE 168
Practice Address - Street 2:SUITE E5
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012-3233
Practice Address - Country:US
Practice Address - Phone:856-227-0720
Practice Address - Fax:856-227-8550
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ04944152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0921403005OtherCIGNA
NJ571436OtherFIRST HEALTH
NJ223048927OtherBCBS
NJ410026820OtherRAILROAD MEDICARE
NJ0426060000OtherAMERIHEALTH
NJ223713OtherUS FAMILY HEALTH PLAN
NJ91001904200OtherAMERICHOICE
NJ1535501Medicaid
NJ603662V4VMedicare PIN
NJ571436OtherFIRST HEALTH