Eumena Divino, | |
390 New Brunswick Ave, Fords, NJ 08863-2110 | |
(732) 738-4260 | |
(732) 738-5693 |
Full Name | Eumena Divino |
---|---|
Gender | Female |
Speciality | Obstetrics & Gynecology |
Location | 390 New Brunswick Ave, Fords, New Jersey |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1225076235 | NPI | - | NPPES |
1108112 | Other | NJ | AETNA HMO # |
P3618222 | Other | NJ | OXFORD # |
2K9373 | Other | NJ | HEALTHNET # |
805E92 | Other | NJ | EMPIRE BCBS (FORDS) |
0102820000 | Other | NJ | AMERIHEALTH # |
0296220 | Other | NJ | GHI PPO # |
4272415 | Other | NJ | AETNA PPO # |
805E91 | Other | NJ | EMPIRE BCBS (PERTH AMBOY) |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207V00000X | Obstetrics & Gynecology | 25MA02674500 (New Jersey) | Primary |
Entity Name | Raritan Bay Medical Center |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1306954243 PECOS PAC ID: 6204820574 Enrollment ID: O20041105000457 |
Mailing Address | Practice Location Address |
---|---|
Eumena Divino, Po Box 48270, Newark, NJ 07101-4800 Ph: (201) 818-9118 | Eumena Divino, 390 New Brunswick Ave, Fords, NJ 08863-2110 Ph: (732) 738-4260 |
Dr. Owobamishola Shonowo, MD Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 565 New Brunswick Ave, Fords, NJ 08863 Phone: 848-203-3520 Fax: 848-203-3627 | |
Dr. Steven Goldberg, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 390 New Brunswick Ave, Fords, NJ 08863 Phone: 732-738-4260 |