Provider Demographics
NPI:1851046338
Name:LOTUS MENTAL HEALTH & WELLNESS
Entity type:Organization
Organization Name:LOTUS MENTAL HEALTH & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DYGULSKI
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:908-731-7031
Mailing Address - Street 1:4514 ROUTE 9 S # 1021
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-3771
Mailing Address - Country:US
Mailing Address - Phone:908-701-7031
Mailing Address - Fax:732-520-3721
Practice Address - Street 1:4514 ROUTE 9 S # 1021
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-3771
Practice Address - Country:US
Practice Address - Phone:908-701-7031
Practice Address - Fax:732-520-3721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-14
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ26NJ00500600OtherSTATE APN LICENSE