Individual
SIJO DEVASIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
385 MORRIS AVE FL 2, SPRINGFIELD, NJ 07081-1151
(973) 379-2111
(973) 379-2807
Mailing address
PO BOX 416457, BOSTON, MA 02241-6457
(844) 362-1735
(973) 290-7495
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00584000
NJ
Other
Enumeration date
11/30/2020
Last updated
12/02/2022
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