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1578041562
SUBY MAMMEN
GASTONIA, NC
NPI
1578041562
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: NC 5010709)
Enumeration Date
2018-08-01
Last Update Date
2018-08-01
Business Address
SUBY MAMMEN NP
2525 COURT DR
GASTONIA, NC 28054-2140
Phone number: 704-834-2000
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Mailing Address
SUBY MAMMEN NP
3352 MANDRAKE CT
TEGA CAY, SC 29708-8806
Phone number: 803-389-6725
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