Individual
ESTELLA MIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
443 STATE ROUTE 34 STE F, MARKETPLACE MALL, MATAWAN, NJ 07747-9506
(732) 583-3600
(732) 583-3770
Mailing address
443 STATE ROUTE 34 STE F, MARKETPLACE MALL, MATAWAN, NJ 07747-9506
(732) 583-3600
(732) 583-3770
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
27OA00507200
NJ
Other
Enumeration date
01/19/2007
Last updated
07/08/2007
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