Healthcare Provider Details

I. General information

NPI: 1033806948
Provider Name (Legal Business Name): PHILIP DAMIAN LENA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2023
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

579A CRANBURY RD STE 103
EAST BRUNSWICK NJ
08816-5426
US

IV. Provider business mailing address

629 CRANBURY RD FL 2
EAST BRUNSWICK NJ
08816-4096
US

V. Phone/Fax

Practice location:
  • Phone: 732-724-3070
  • Fax:
Mailing address:
  • Phone: 732-390-7750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MA12893600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: