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General NPI Number Information
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NPI Number | 1528920980
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Entity Type | Organization
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Legal Business Name | OCEAN WOUNDS IN LLC
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Dates
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Enumeration Date | 11/24/2025
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 110 BEVERLY DR
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City | CHESTERTON
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State | IN
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Zip | 46304-9368
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Country | US
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Telephone | 347-829-6863
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Fax |
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Provider Business Mailing Address
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Address Line | 144 COLES WAY
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City | LAKEWOOD
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State | NJ
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Zip | 08701-4885
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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 | ELYSSE LERNER
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Credential |
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Telephone | 845-901-7289
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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