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Organization
SPARKLE MEDICAL PA
Active
Organization
SPARKLE MEDICAL PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SEEMA S RAO MD (OWNER)
(908) 548-8355
Entity
Organization
Contact information
Practice address
1550 PARK AVENUE, SUIT 104, SOUTH PLAINFIELD, NJ 07080
(908) 548-8355
(908) 548-8359
Mailing address
1550 PARK AVE, SUITE 104, SO. PLAINFIELD, NJ 07080
(908) 548-8355
(908) 548-8359
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0220868
—
NJ
Enumeration date
02/12/2009
Last updated
04/04/2014
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