Organization
MARTIN A KITAGAWA
Active
Other names
Martin A Kitagawa, O.D. & Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN A KITAGAWA O.D. (OWNER)
(856) 848-3162
Entity
Organization
Contact information
Practice address
1750 DEPTFORD CENTER RD, DEPTFORD, NJ 08096-5222
(856) 848-3162
Mailing address
1750 DEPTFORD CENTER RD, DEPTFORD, NJ 08096-5222
(856) 848-3162
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
27OA 00436200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116915
EYEMED GROUP NUMBER
—
01
—
2592370
AETNA GROUP NUMBER
—
Enumeration date
03/26/2007
Last updated
08/22/2020
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