Healthcare Provider Details

I. General information

NPI: 1689857682
Provider Name (Legal Business Name): VERONICA LYTE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2007
Last Update Date: 12/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 SPRINGDALE RD
MANCHESTER NJ
08759-5160
US

IV. Provider business mailing address

9 SPRINGDALE RD
MANCHESTER NJ
08759-5160
US

V. Phone/Fax

Practice location:
  • Phone: 732-350-3999
  • Fax:
Mailing address:
  • Phone: 732-350-3999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number25MA04187500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: