Provider Demographics
NPI:1154564730
Name:MOSAIC FAMILY HEALTH
Entity type:Organization
Organization Name:MOSAIC FAMILY HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BINOY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHERIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-235-1601
Mailing Address - Street 1:993 LENOX DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2316
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:136 FRANKLIN CORNER RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2502
Practice Address - Country:US
Practice Address - Phone:609-235-1800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-13
Last Update Date:2009-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty