Provider Demographics
NPI:1346830403
Name:SITENGA EYE ASSOCIATES LLC
Entity Type:Organization
Organization Name:SITENGA EYE ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GARRET
Authorized Official - Middle Name:LAMENDOLA
Authorized Official - Last Name:SITENGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:907-335-3358
Mailing Address - Street 1:115 BIDARKA ST
Mailing Address - Street 2:
Mailing Address - City:KENAI
Mailing Address - State:AK
Mailing Address - Zip Code:99611-7741
Mailing Address - Country:US
Mailing Address - Phone:907-335-3358
Mailing Address - Fax:907-335-4358
Practice Address - Street 1:115 BIDARKA ST
Practice Address - Street 2:
Practice Address - City:KENAI
Practice Address - State:AK
Practice Address - Zip Code:99611-7741
Practice Address - Country:US
Practice Address - Phone:907-335-3358
Practice Address - Fax:907-335-4358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-22
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty