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General NPI Number Information
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NPI Number | 1821582347
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Entity Type | Individual
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Provider Name | LUIS MEJIA SIERRA
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Gender | Male
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Dates
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Enumeration Date | 06/18/2018
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 212 CREEK CROSSING BLVD
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City | HAINESPORT
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State | NJ
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Zip | 08036-2766
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Country | US
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Telephone | 609-267-1004
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Fax | 609-267-1044
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Provider Business Mailing Address
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Address Line | 301 LIPPINCOTT DR STE 410
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City | MARLTON
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State | NJ
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Zip | 08053-4197
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Country | US
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Telephone | 609-267-1004
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Fax | 609-267-1044
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MT215176
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 25MA12743700
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License Number State | NJ
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