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500 River Ave Lakewood NJ 08701-4721 | |
| (732) 363-1900 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center |
| Location | 500 River Ave, Lakewood, New Jersey |
| Authorized Official Name and Position | Anthony Lombardino (V.P. OF MEDICAL AFFAIRS) |
| Authorized Official Contact | 7323631900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
415 Birch Bark Dr Brick NJ 08723-4903 Ph: (732) 477-3334 | 500 River Ave Lakewood NJ 08701-4721 Ph: (732) 363-1900 |
| NPI Number | 1174677264 |
|---|---|
| Provider Enumeration Date | 01/23/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174677264 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 26NN08747500 (New Jersey) | Primary |
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