Healthy Life Md., Llc | |
3840 Park Ave Ste 103 Edison NJ 08820-2563 | |
(732) 515-9944 | |
(732) 515-9945 |
Full Name | Healthy Life Md., Llc |
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Speciality | Internal Medicine |
Location | 3840 Park Ave Ste 103, Edison, New Jersey |
Authorized Official Name and Position | Shobana Natarajan (SOLE OWNER) |
Authorized Official Contact | 7325159944 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Healthy Life Md., Llc 3840 Park Ave Ste 103 Edison NJ 08820-2563 Ph: (732) 515-9944 | Healthy Life Md., Llc 3840 Park Ave Ste 103 Edison NJ 08820-2563 Ph: (732) 515-9944 |
NPI Number | 1972041143 |
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Provider Enumeration Date | 02/07/2017 |
Last Update Date | 02/07/2017 |
Medicare PECOS PAC ID | 8426327891 |
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Medicare Enrollment ID | O20170629000297 |
Identifier | Type | State | Issuer |
---|---|---|---|
1972041143 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Shobana Natarajan |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1639174394 PECOS PAC ID: 5597667170 Enrollment ID: I20040123000620 |
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