| NPI | 1073662417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOVELY SEBASTIAN MATHEW Physician 732-390-7552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: NJ MA071970) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2020-08-22 |