Eternally Acp PC

Primary specialty

Health EducatorTaxonomy code 174H00000X

Legal business name

ETERNALLY ACP PC

Practice address

693 Main St Ste D
Lumberton, NJ 08048-5043

Phone

(267) 764-4704

NPI assigned

Mar 11, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mayank Mathur, MD

Title

Owner

Phone

(267) 764-4704

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1646956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646956800000",
    "number": "1306594163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 FORREST AVE APT 3",
            "city": "NARBERTH",
            "state": "PA",
            "postal_code": "190722215",
            "telephone_number": "267-764-4704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "693 MAIN ST STE D",
            "city": "LUMBERTON",
            "state": "NJ",
            "postal_code": "080485043",
            "telephone_number": "267-764-4704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETERNALLY ACP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-11",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A",
        "authorized_official_last_name": "MATHUR",
        "authorized_official_first_name": "MAYANK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "267-764-4704",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donise Paullette Dumpson, CRNA
• Desiree Durow
• Amanda Paige Elker England, LCSW, LCADC
• Equal Partners Inc
• Eric J. Hartman M.D. LLC
• Margaret Louise Facey-Campbell, O.D.
• Elisa Faulk, D.P.M.
• Jennifer K Fehl, BCBA
• Beaudelair Fils, PHARMD
• Demonai L Finley

• Health Educator in Lumberton, NJ
• Providers in Lumberton, NJ by specialty
• Health Educator in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.