Lumina Psychiatry Group Llc | |
833 Lacey Rd Ste 6 Forked River NJ 08731-1200 | |
(201) 614-5900 | |
(201) 366-6690 |
Full Name | Lumina Psychiatry Group Llc |
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Speciality | Nurse Practitioner |
Location | 833 Lacey Rd Ste 6, Forked River, New Jersey |
Authorized Official Name and Position | Daniel Bhagat (CEO) |
Authorized Official Contact | 2016145900 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Lumina Psychiatry Group Llc Po Box 7903 Philadelphia PA 19101-7903 Ph: () - | Lumina Psychiatry Group Llc 833 Lacey Rd Ste 6 Forked River NJ 08731-1200 Ph: (201) 614-5900 |
NPI Number | 1720846496 |
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Provider Enumeration Date | 03/07/2024 |
Last Update Date | 03/07/2024 |
Certification Date | 03/07/2024 |
Medicare PECOS PAC ID | 1254779135 |
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Medicare Enrollment ID | O20240411000861 |
Identifier | Type | State | Issuer |
---|---|---|---|
1720846496 | NPI | - | NPPES |
Provider Name | Liju Mathew |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477948578 PECOS PAC ID: 1951606714 Enrollment ID: I20160428000853 |
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