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General NPI Number Information
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NPI Number | 1447425590
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Entity Type | Organization
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Legal Business Name | RONALD J. LANCZ,DPM P.A.
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Dates
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Enumeration Date | 04/29/2008
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Last Update Date | 02/01/2011
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Provider Practice Location Address
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Address Line | 721 W KENNEDY BLVD SUITE B5
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City | LAKEWOOD
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State | NJ
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Zip | 08701-1255
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Country | US
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Telephone | 732-364-4300
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Fax | 732-886-7363
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Provider Business Mailing Address
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Address Line | 721 W KENNEDY BLVD SUITE B5
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City | LAKEWOOD
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State | NJ
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Zip | 08701-1255
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Country | US
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Telephone | 732-364-4300
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Fax | 732-886-7363
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Authorized Official
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Title or Position | OWNER
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Name | DR. RONALD J LANCZ
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Credential | DPM
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Telephone | 732-364-4300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP1100X
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Taxonomy Name | Podiatric Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | MD002201
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License Number State | NJ
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