Organization
SANTAMARIA EYE CENTER P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS MENCIA DISLA (PRACTICE ADMINISTRATOR)
(732) 826-5159
Entity
Organization
Contact information
Practice address
104 MARKET ST, PERTH AMBOY, NJ 08861-4412
(732) 826-5159
(732) 826-2107
Mailing address
104 MARKET ST, PERTH AMBOY, NJ 08861-4412
(732) 826-5159
(732) 826-2107
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MA034125
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0074584000
AMERIHEALTH
NJ
01
—
1093155
HORIZON NJ HEALTH
NJ
01
—
27003
UNIVERSITY HEALTH PLAN
NJ
01
—
352731
MEDICARE OF NY
NY
05
—
8940703
—
NJ
01
—
LS342
OXFORD
NJ
01
—
OK7192
HEALTHNET OF NJ
NJ
Enumeration date
11/08/2005
Last updated
03/25/2019
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