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LAKESIDE NEUROLOGY & RADIOLOGY OF NEW JERSEY PC NPI 1356537708


NPI Information

NPI: 1356537708
Provider Name: LAKESIDE NEUROLOGY & RADIOLOGY OF NEW JERSEY PC

Doing Business As: LAKESIDE NEUROLOGY OF NEW JERSEY

Classification: Specialist - 174400000X
Entity Type: Organization
Address:
1 GATEWAY CTR
#2600
NEWARK, NJ
ZIP 07102
Phone: (847) 510-0530
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LAKESIDE NEUROLOGY & RADIOLOGY OF NEW JERSEY PC is a specialist in Newark, NJ. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. LAKESIDE NEUROLOGY & RADIOLOGY OF NEW JERSEY PC NPI is 1356537708. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Lakeside Neurology Of New Jersey.

The provider's business location address is:

1 GATEWAY CTR
#2600
NEWARK, NJ
ZIP 07102-310
Phone: (847) 510-0530
Fax: (888) 317-4206

The provider's authorized official is Tom G Winger .
The authorized official title is Director and has the following contact phone number (847) 510-0530.

The enumeration date for this NPI number is 9/19/2007 and was last updated on 11/12/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialist25MA07746800NEW JERSEYYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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