| Kendall Park Medical Group | |
|
3 Stanworth Rd # A Kendall Park NJ 08824-1003 | |
| (732) 940-0505 | |
| (732) 940-1997 |
| Full Name | Kendall Park Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 3 Stanworth Rd # A, Kendall Park, New Jersey |
| Authorized Official Name and Position | Jaime F Lara (PHYSICIAN) |
| Authorized Official Contact | 7329400505 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kendall Park Medical Group 3 Stanworth Rd # A Kendall Park NJ 08824-1003 Ph: (732) 940-0505 | Kendall Park Medical Group 3 Stanworth Rd # A Kendall Park NJ 08824-1003 Ph: (732) 940-0505 |
| NPI Number | 1477784155 |
|---|---|
| Provider Enumeration Date | 07/29/2009 |
| Last Update Date | 07/29/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477784155 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 25MA04235300 (New Jersey) | Primary |
Lingping Gu Md Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3084 State Route 27 Ste 9, Kendall Park, NJ 08824 Phone: 732-297-4321 Fax: 732-297-2202 | |
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