Provider Demographics
NPI:1669628855
Name:MARY MADHURI NATH
Entity Type:Organization
Organization Name:MARY MADHURI NATH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:NATH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-331-3209
Mailing Address - Street 1:8403 HANA RD
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-2003
Mailing Address - Country:US
Mailing Address - Phone:732-331-3209
Mailing Address - Fax:
Practice Address - Street 1:146 NEW BRUNSWICK AVE
Practice Address - Street 2:
Practice Address - City:HOPELAWN
Practice Address - State:NJ
Practice Address - Zip Code:08861-2242
Practice Address - Country:US
Practice Address - Phone:732-697-1919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-07
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07789000207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty