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General NPI Number Information
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NPI Number | 1477845055
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Entity Type | Organization
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Legal Business Name | NEW JERSEY FAMILY MEDICAL
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Dates
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Enumeration Date | 05/13/2011
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Last Update Date | 04/18/2024
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Provider Practice Location Address
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Address Line | 27 SOUTH AVE W
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City | CRANFORD
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State | NJ
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Zip | 07016-2660
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Country | US
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Telephone | 908-275-3810
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Fax | 908-275-8825
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Provider Business Mailing Address
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Address Line | 27 SOUTH AVE W
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City | CRANFORD
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State | NJ
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Zip | 07016-2660
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Country | US
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Telephone | 908-275-3810
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Fax | 908-275-8825
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT LUKENDA
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Credential | D.O.
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Telephone | 908-275-3810
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MB08803900
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License Number State | NJ
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