Provider Demographics
NPI:1780719518
Name:FERRER GARCIA, DELIA M (OD)
Entity type:Individual
Prefix:DR
First Name:DELIA
Middle Name:M
Last Name:FERRER GARCIA
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 1:1160 MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-2251
Mailing Address - Country:US
Mailing Address - Phone:973-472-2828
Mailing Address - Fax:973-472-2838
Practice Address - Street 1:1160 MAIN AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-2251
Practice Address - Country:US
Practice Address - Phone:973-472-2828
Practice Address - Fax:973-472-2838
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00511700152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJFE618569Medicare ID - Type Unspecified
NJU19815Medicare UPIN