Individual
MIA DECAPUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
714 STATION AVE, HADDON HEIGHTS, NJ 08035-1636
(856) 546-8686
(856) 546-0959
Mailing address
420 MOUNTAIN AVE FL 4, NEW PROVIDENCE, NJ 07974-2736
(856) 691-8188
(856) 691-0421
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
27OA00706700
NJ
Other
Enumeration date
07/28/2021
Last updated
02/14/2025
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