Provider Demographics
NPI:1326092065
Name:DALESSANDRO, DAVID (OD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:DALESSANDRO
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 1:1029 MC BRIDE AVE
Mailing Address - Street 2:
Mailing Address - City:WOODLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07424-2534
Mailing Address - Country:US
Mailing Address - Phone:973-890-9044
Mailing Address - Fax:973-890-9054
Practice Address - Street 1:AMAZING EYES
Practice Address - Street 2:1029 MC BRIDE AVE
Practice Address - City:WOODLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:07424-2534
Practice Address - Country:US
Practice Address - Phone:973-890-9044
Practice Address - Fax:973-890-9054
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00536300152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0108219Medicaid
NJ0108219Medicaid
NJU57078Medicare UPIN