Healthcare Provider Details

I. General information

NPI: 1346159464
Provider Name (Legal Business Name): MA'REE SANSBURY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 ROUTE 130 S
CINNAMINSON NJ
08077-3075
US

IV. Provider business mailing address

2501 ROUTE 130 S
CINNAMINSON NJ
08077-3075
US

V. Phone/Fax

Practice location:
  • Phone: 856-786-0530
  • Fax: 856-786-0539
Mailing address:
  • Phone: 856-786-0530
  • Fax: 856-786-0539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number3TD00428300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: