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Organization

LIFESTYLE MEDICINE CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MADHU MATHUR MD (DIRECTOR)
(203) 614-8517
Entity
Organization

Contact information

Practice address
2777 SUMMER ST, SUITE 604, STAMFORD, CT 06905-4318
(203) 614-8517
(203) 614-8518
Mailing address
2777 SUMMER ST, SUITE 604, STAMFORD, CT 06905-4318
(203) 614-8517
(203) 614-8518

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
039624
CT

Other

Enumeration date
03/26/2014
Last updated
03/26/2014
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