Healthcare Provider Details

I. General information

NPI: 1114115730
Provider Name (Legal Business Name): LUC J LEMMERLING MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2007
Last Update Date: 10/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 EWING ST SUITE A-4
PRINCETON NJ
08540-2757
US

IV. Provider business mailing address

601 EWING ST SUITE A-4
PRINCETON NJ
08540-2757
US

V. Phone/Fax

Practice location:
  • Phone: 609-921-1500
  • Fax: 609-497-1444
Mailing address:
  • Phone: 609-921-1500
  • Fax: 609-497-1444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number25MA03016500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: