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Individual

DR. JAY DEMESQUITA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
4222 WESTFIELD AVE, PENNSAUKEN, NJ 08110-3010
(856) 964-1058
(856) 662-0299
Mailing address
4222 WESTFIELD AVE, PENNSAUKEN, NJ 08110-3010
(856) 964-1058
(856) 662-0299

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
27OA00367000
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0K9077
HEALTH NET MATERIALS
NJ
05
1373501
NJ
01
18220
SPECTERA/AMERICHOICE
NJ
01
310045
NATL VISION ADMINISTRATOR
NJ
01
33221
AETNA
NJ
01
F09873
HEALTH NET
NJ
01
NJ03620
VISION BENEFITS OF AMERIC
NJ
Enumeration date
10/16/2006
Last updated
10/07/2008
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