Individual
EUMENA DIVINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
390 NEW BRUNSWICK AVE, FORDS, NJ 08863-2110
(732) 738-4260
(732) 738-5693
Mailing address
PO BOX 48270, NEWARK, NJ 07101-4800
(201) 818-9118
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
25MA02674500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0102820000
AMERIHEALTH #
NJ
01
—
0296220
GHI PPO #
NJ
01
—
1108112
AETNA HMO #
NJ
01
—
2K9373
HEALTHNET #
NJ
01
—
4272415
AETNA PPO #
NJ
01
—
805E91
EMPIRE BCBS (PERTH AMBOY)
NJ
01
—
805E92
EMPIRE BCBS (FORDS)
NJ
01
—
P3618222
OXFORD #
NJ
Enumeration date
06/02/2006
Last updated
04/16/2008
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