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General NPI Number Information
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NPI Number | 1386744571
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Entity Type | Organization
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Legal Business Name | LYNDHURST MEDICAL ASSOC., P.A.
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 12/03/2012
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Provider Practice Location Address
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Address Line | 1033 CLIFTON AVE SUITE 102
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City | CLIFTON
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State | NJ
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Zip | 07013-3517
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Country | US
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Telephone | 201-460-0142
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Fax | 973-473-7085
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Provider Business Mailing Address
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Address Line | 1033 CLIFTON AVE SUITE 102
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City | CLIFTON
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State | NJ
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Zip | 07013-3517
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Country | US
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Telephone | 201-460-0142
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Fax | 973-473-7085
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | ELLEN P BROWN
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Credential |
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Telephone | 973-777-9124
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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