Lawrence Grill Mdpa

NPI 1275561326 - Internal Medicine - 207R00000X

NPI Details
NPI 1275561326
Enumeration Date 06/29/2006
Last Updated 06/12/2012
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name KELLY A KELLY
Position OFFICE MANAGER
Phone (732) 367-8272
Fax
Practice Location
1166 RIVER AVE
LAKEWOOD NJ, 08701-5600, US
Phone (732) 367-8272
Fax
Business Location
1166 RIVER AVE
LAKEWOOD NJ, 08701-5600, US
Phone (732) 367-8272
Fax
Toxanomy
Taxonomy Code 207R00000X
License State
License Number
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According to our database, Lawrence Grill Mdpa NPI is 1275561326, taxonomy code is 207R00000X Lawrence Grill Mdpa physically located at 1166 River Ave, Lakewood NJ, 08701-5600. NPI Number 1033115704 has the healthcare provider type.

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1275561326 NPI number is provided on an as is basis without warranty of any kind. 1275561326 is maintained by the National Plan & Provider Enumeration System. The contents of Lawrence Grill Mdpa are for informational purposes only.