| Lanza's Medical Center, Llc | |
|
240 Maple Ave Red Bank NJ 07701-1731 | |
| (732) 576-1600 | |
| Not Available |
| Full Name | Lanza's Medical Center, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 240 Maple Ave, Red Bank, New Jersey |
| Authorized Official Name and Position | Michele R Lanza (PRESIDENT) |
| Authorized Official Contact | 7325761600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lanza's Medical Center, Llc 240 Maple Ave Red Bank NJ 07701-1731 Ph: (732) 576-1600 | Lanza's Medical Center, Llc 240 Maple Ave Red Bank NJ 07701-1731 Ph: (732) 576-1600 |
| NPI Number | 1235522236 |
|---|---|
| Provider Enumeration Date | 03/15/2015 |
| Last Update Date | 11/06/2015 |
| Medicare PECOS PAC ID | 5799090122 |
|---|---|
| Medicare Enrollment ID | O20150814012744 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235522236 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (New Jersey) | Primary |
| Provider Name | Michele R Lanza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558370635 PECOS PAC ID: 9931291846 Enrollment ID: I20070823000458 |
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