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General NPI Number Information
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NPI Number | 1215552914
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Entity Type | Organization
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Legal Business Name | SME NEW JERSEY P.C.
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Dates
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Enumeration Date | 06/09/2020
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Last Update Date | 06/09/2020
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Provider Practice Location Address
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Address Line | 3600 ROUTE 66 STE 150
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City | NEPTUNE
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State | NJ
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Zip | 07753-2645
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Country | US
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Telephone | 347-294-0581
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Fax |
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Provider Business Mailing Address
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Address Line | 4321 COLLINGTON RD
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City | BOWIE
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State | MD
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Zip | 20716-2259
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LEV GRINMAN
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Credential |
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Telephone | 347-294-0581
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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