Eumena Divino

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

25MA02674500 Issued in NJ

Practice address

390 New Brunswick Ave
Fords, NJ 08863-2110

Phone

(732) 738-4260

Fax

(732) 738-5693

NPI assigned

Jun 2, 2006

Last updated

Apr 16, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Raritan Bay Medical Center Professional Services

  • Specialist
  • Fords, NJ
  • NPI 1245330588
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208304000000",
    "number": "1225076235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 48270",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071014800",
            "telephone_number": "201-818-9118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 NEW BRUNSWICK AVE",
            "city": "FORDS",
            "state": "NJ",
            "postal_code": "088632110",
            "telephone_number": "732-738-4260",
            "fax_number": "732-738-5693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIVINO",
        "first_name": "EUMENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2008-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "25MA02674500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO #",
            "identifier": "1108112",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET #",
            "identifier": "2K9373",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BCBS (FORDS)",
            "identifier": "805E92",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BCBS (PERTH AMBOY)",
            "identifier": "805E91",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD #",
            "identifier": "P3618222",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH #",
            "identifier": "0102820000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI PPO #",
            "identifier": "0296220",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO #",
            "identifier": "4272415",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zakia Clay, MSW, LCSW
• Cutrite Surgical Supply, Inc (Woodbridge Medical & Surgical Supply)
• Anil Datwani, PHARM D
• James Michael Destefano, LCSW
• John Z Didomenico, DC
• Melanie Grace Dumandan, RN
• Stella Efthymiou-Backos, DDS
• Tara Ehmann, LPC
• Emergency Medical Associates
• Armie Farcon, D.M.D.

• Obstetrics & Gynecology Physician in Fords, NJ
• Providers in Fords, NJ by specialty
• Obstetrics & Gynecology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.