Provider Demographics
NPI:1073662417
Name:DR. RADHAKRISHNA & ASSOCIATES
Entity Type:Organization
Organization Name:DR. RADHAKRISHNA & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LOVELY
Authorized Official - Middle Name:SEBASTIAN
Authorized Official - Last Name:MATHEW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-390-7552
Mailing Address - Street 1:2 LEXINGTON RD
Mailing Address - Street 2:
Mailing Address - City:MONMOUTH JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08852-3085
Mailing Address - Country:US
Mailing Address - Phone:732-274-0071
Mailing Address - Fax:
Practice Address - Street 1:155 STELTON RD
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-3251
Practice Address - Country:US
Practice Address - Phone:732-752-8442
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA071970261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center