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SHORE MEDICINE LLC NPI 1972638039


NPI Information

NPI: 1972638039
Provider Name: SHORE MEDICINE LLC
Classification: Internal Medicine - 207RG0300X
Entity Type: Organization

Specialization: Geriatric Medicine

CLIA Number: 31D1049631

Address:
1255 HIGHWAY 70
SUITE 24-S
LAKEWOOD, NJ
ZIP 08701
Phone: (732) 730-0020
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SHORE MEDICINE LLC is a geriatric medicine internal medicine in Lakewood, NJ. The provider is an internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. SHORE MEDICINE LLC NPI is 1972638039. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1255 HIGHWAY 70
SUITE 24-S
LAKEWOOD, NJ
ZIP 08701-900
Phone: (732) 730-0020
Fax: (732) 730-0035

The provider's authorized official is Manjula Thopcherla .
The authorized official title is President and has the following contact phone number (732) 730-0020.

The CLIA number assigned to this NPI record is 31D1049631 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/22/2007 and was last updated on 10/26/2007.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RG0300XInternal MedicineGeriatric MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1099320MEDICARE ID-TYPE UNSPECIFIEDNEW JERSEYPRACTICE MEDICARE ID
2DE4170OTHERNEW JERSEYPALMETTO GBA RAILROAD MED

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: 5/5/2024

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