Mena, Maria Gutierrez

Mena, Maria Gutierrez is an individual health care provider with primary practice located at 418 57Th St , West New York NJ 07093-2120. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Mena, Maria Gutierrez can be contacted via phone (201) 868-5391.

Contact Information

Primary practice address
418 57Th St West New York NJ 07093-2120
Phone: (201) 868-5391
Fax: (201) 453-1054
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 25MA03403300 New Jersey

Profile Details

NPI number 1154318111
LBN Legal business name Mena, Maria Gutierrez
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 4th, 2005
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154318111 NPPES
New Jersey MEDICAID 1258605

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