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Individual

MARK LEE NIEMIERA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
613 AMBOY AVE, SUITE 104, PERTH AMBOY, NJ 08861-2577
(732) 442-1441
(732) 442-7684
Mailing address
613 AMBOY AVE, SUITE 104, PERTH AMBOY, NJ 08861-2577
(732) 442-1441
(732) 442-7684

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
25MAO4370700
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0105202000
AMERIHEALTH
01
060022093
RAILROAD MEDICARE
01
0997948
CIGNA
01
0K5093
HEALTHNET
01
10145
UNIVERSITY HEALTH PLAN
01
13611
AMERIGROUP
05
1905902-01
NJ
01
241137
UNITED HEALTHCARE
01
28022
LOCAL 825 FUND
01
37769
AETNA US HEALTHCARE
01
4094350
AETNA US HEALTHCARE
01
455090
AMERIHEALTH
01
68713
GHI
01
77K03
EMPIRE HEALTHCARE
01
LS183
OXFORD
Enumeration date
09/08/2006
Last updated
02/19/2010
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