SANTA MARIA MEDICAL GROUPP.A. NPI 1912147190

NPI Information

SANTA MARIA MEDICAL GROUP,P.A. is a primary care clinic center in Kearny, NJ. SANTA MARIA MEDICAL GROUP,P.A. NPI is 1912147190. The provider is registered as an organization entity type.

The provider's business location address is:

845 KEARNY AVE
KEARNY, NJ
ZIP 07032-244
Phone: (201) 991-1129
Fax: (201) 991-2799

The provider's authorized official is Mauricio Jorge Sanchez .
The authorized official title is Owner and has the following contact phone number (201) 246-9272.

The CLIA number assigned to this NPI record is 31D2169898 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/27/2009 and was last updated on 2/27/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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