| Mini Mine Llc | |
|
128 Melville Ave Lakewood NJ 08701-4235 | |
| (732) 886-8113 | |
| Not Available |
| Full Name | Mini Mine Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 128 Melville Ave, Lakewood, New Jersey |
| Authorized Official Name and Position | Malka Nussbaum (CLINICAL DIRECTOR) |
| Authorized Official Contact | 7328868113 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mini Mine Llc 128 Melville Ave Lakewood NJ 08701-4235 Ph: (732) 886-8113 | Mini Mine Llc 128 Melville Ave Lakewood NJ 08701-4235 Ph: (732) 886-8113 |
| NPI Number | 1003557224 |
|---|---|
| Provider Enumeration Date | 04/03/2022 |
| Last Update Date | 06/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003557224 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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