Healthcare Provider Details
I. General information
NPI: 1649329939
Provider Name (Legal Business Name): LAWRENCE MEYERS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/09/2007
Last Update Date: 07/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
324 SOUTH AVE E
WESTFIELD NJ
07090-1459
US
IV. Provider business mailing address
324 SOUTH AVE E
WESTFIELD NJ
07090-1459
US
V. Phone/Fax
- Phone: 908-232-2727
- Fax: 908-232-5893
- Phone: 908-232-2727
- Fax: 908-232-5893
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ND0101X |
| Taxonomy | MOHS-Micrographic Surgery Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ND0900X |
| Taxonomy | Dermatopathology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207NS0135X |
| Taxonomy | Procedural Dermatology Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208200000X |
| Taxonomy | Plastic Surgery Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207N00000X |
| Taxonomy | Dermatology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
LAWRENCE
S.
MEYERS
Title or Position: OWNER
Credential: M.D.
Phone: 908-232-2727