Sijo Devasia
Physician Assistant in Springfield, NJ. Individual provider (NPI-1).
NPI number1366046492
StatusActive
Last updated in NPPESDec 2, 2022
Details
- NPI
- 1366046492
- Entity type
- Individual (NPI-1)
- Name
- Sijo Devasia
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Nov 30, 2020
- Certification date
- Dec 2, 2022
- Last updated
- Dec 2, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 25MP00584000 | NJ | Yes |
Practice location
385 Morris Ave Fl 2Springfield, NJ 07081-1151
Phone 973-379-2111 · Fax 973-379-2807
Mailing address
Po Box 416457Boston, MA 02241-6457
Phone 844-362-1735 · Fax 973-290-7495
Other practice locations
741 Northfield Ave Ste 203
West Orange, NJ 07052-1104
West Orange, NJ 07052-1104
Phone 973-379-2111 · Fax 973-379-2807
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