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General NPI Number Information
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NPI Number | 1073662417
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Entity Type | Organization
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Legal Business Name | DR. RADHAKRISHNA & ASSOCIATES
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 155 STELTON RD
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City | PISCATAWAY
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State | NJ
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Zip | 08854-3251
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Country | US
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Telephone | 732-752-8442
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Fax |
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Provider Business Mailing Address
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Address Line | 2 LEXINGTON RD
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City | MONMOUTH JUNCTION
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State | NJ
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Zip | 08852-3085
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Country | US
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Telephone | 732-274-0071
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. LOVELY SEBASTIAN MATHEW
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Credential | M.D.
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Telephone | 732-390-7552
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | MA071970
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License Number State | NJ
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