Healthcare Provider Details

I. General information

NPI: 1891910600
Provider Name (Legal Business Name): LYMPHEDEMA PHYSICIAN SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 03/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S ORANGE AVE
LIVINGSTON NJ
07039-5817
US

IV. Provider business mailing address

200 S ORANGE AVE
LIVINGSTON NJ
07039-5817
US

V. Phone/Fax

Practice location:
  • Phone: 973-322-7366
  • Fax:
Mailing address:
  • Phone: 973-322-7366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081H0002X
TaxonomyHospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KATHLEEN FRANCIS
Title or Position: OWNER
Credential: MD
Phone: 973-322-7366