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1771 Madison Ave Lakewood NJ 08701-1242 | |
| (732) 364-6666 | |
| (732) 364-3559 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1771 Madison Ave, Lakewood, New Jersey |
| Authorized Official Name and Position | David Friedman (CEO) |
| Authorized Official Contact | 7323642144 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1771 Madison Ave Lakewood NJ 08701-1242 Ph: (732) 364-6666 | 1771 Madison Ave Lakewood NJ 08701-1242 Ph: (732) 364-6666 |
| NPI Number | 1205644333 |
|---|---|
| Provider Enumeration Date | 12/20/2024 |
| Last Update Date | 12/20/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205644333 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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