Organization
SEBASTIAN MEDICAL ASSOCIATES CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNAMARIA CONKLIN (CREDENTIALING COORDINATOR)
(973) 458-0422
Entity
Organization
Contact information
Practice address
476 COLFAX AVE, CLIFTON, NJ 07013-1624
(973) 594-7977
(973) 594-9983
Mailing address
PO BOX 1719, CLIFTON, NJ 07015-1719
(973) 458-0422
(973) 458-0661
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MA08164800
NJ
Other
Enumeration date
04/03/2007
Last updated
12/01/2008
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