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Individual

LEELAMMA J MATHEW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APN

Contact information

Practice address
310 CENTRAL AVE, 102, EAST ORANGE, NJ 07018-2835
(973) 395-1550
(973) 395-3711
Mailing address
668 COLONIAL ARMS RD, UNION, NJ 07083-7608
(908) 688-4827

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
26NJ00448400
NJ

Other

Enumeration date
07/15/2013
Last updated
04/28/2014
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