Mirra, Dennis R

Mirra, Dennis R is an individual health care provider with primary practice located at 885 S Governors Ave , Dover DE 19904-4158. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Mirra, Dennis R can be contacted via phone (302) 734-5861.

Contact Information

Primary practice address
885 S Governors Ave Dover DE 19904-4158
Phone: (302) 734-5861
Fax: (302) 734-1921
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X I3-0001149 Delaware

Profile Details

NPI number 1295720522
LBN Legal business name Mirra, Dennis R
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 13th, 2005
Last updated Jan 31st, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295720522 NPPES
Delaware MEDICAID 0000302622
Delaware Other 510292224
Delaware Other P01245272
Delaware Other 4405500
Delaware Other 1603
Delaware Other B86041

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