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General NPI Number Information
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NPI Number | 1629108048
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Entity Type | Individual
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Provider Name | SANDRA E TUBITO O.D.
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Gender | Female
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 05/04/2016
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Provider Practice Location Address
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Address Line | 11 HORSESHOE DR
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City | FLEMINGTON
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State | NJ
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Zip | 08822-3345
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Country | US
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Telephone | 908-284-9513
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Fax |
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Provider Business Mailing Address
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Address Line | 11 HORSESHOE DR
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City | FLEMINGTON
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State | NJ
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Zip | 08822-3345
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Country | US
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Telephone | 908-284-9513
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 27TO00120500
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License Number State | NJ
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