Provider Demographics
NPI:1962209163
Name:ESPERACION, DEBBIE LYN (LICENSED OPTICIAN)
Entity type:Individual
Prefix:
First Name:DEBBIE LYN
Middle Name:
Last Name:ESPERACION
Suffix:
Gender:
Credentials:LICENSED OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 88TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-4709
Mailing Address - Country:US
Mailing Address - Phone:201-758-2895
Mailing Address - Fax:201-758-2897
Practice Address - Street 1:2100 88TH ST
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-4709
Practice Address - Country:US
Practice Address - Phone:201-758-2895
Practice Address - Fax:201-758-2897
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ31TD00405400156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty