Organization
SANTA MARIA CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAURICIO JORGE SANCHEZ MD (OWNER)
(201) 991-1129
Entity
Organization
Contact information
Practice address
845 KEARNY AVE, KEARNY, NJ 07032-3244
(201) 991-1129
(201) 991-2272
Mailing address
845 KEARNY AVE, KEARNY, NJ 07032-3244
(201) 991-1129
(201) 991-2272
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
25MA06334400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
235585
MEDICARE PTAN
—
Enumeration date
04/05/2012
Last updated
04/05/2012
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