Provider Demographics
NPI:1043629876
Name:SEBASTIAN MATHEW, LOVELY (MD)
Entity Type:Individual
Prefix:DR
First Name:LOVELY
Middle Name:
Last Name:SEBASTIAN MATHEW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LOVELY
Other - Middle Name:
Other - Last Name:SEBASTIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:155, STELTON ROAD
Mailing Address - Street 2:
Mailing Address - City:PISCATWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854
Mailing Address - Country:US
Mailing Address - Phone:732-752-8442
Mailing Address - Fax:732-752-3957
Practice Address - Street 1:155, STELTON ROAD
Practice Address - Street 2:
Practice Address - City:PISCATWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854
Practice Address - Country:US
Practice Address - Phone:732-752-8442
Practice Address - Fax:732-752-3957
Is Sole Proprietor?:No
Enumeration Date:2014-08-06
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07197000208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics