Individual
SANDRA EVE VAUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
100 W REDBANK, SETO MEDICAL PROVIDERS, W. DEPTFORD, NJ 08096-3407
(856) 241-3311
(856) 241-3969
Mailing address
100 W REDBANK, W. DEPTFORD, NJ 08096-3407
(856) 241-3311
(856) 241-3969
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MA059140
NJ
207N00000X
Dermatology Physician
ME129987
FL
207ND0101X
MOHS-Micrographic Surgery Physician
MA059140
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019587900
—
FL
01
—
0456393
AETNA
NJ
01
—
070010774
RAILROAD MEDICARE
NJ
05
—
5653606
—
NJ
01
—
616834
HORIZON BC BS OF NJ
NJ
Enumeration date
11/15/2006
Last updated
11/08/2021
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