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General NPI Number Information
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NPI Number | 1700691417
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Entity Type | Organization
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Legal Business Name | LMBC MEDICAL SERVICES NEW JERSEY P.C.
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Dates
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Enumeration Date | 02/10/2025
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 100 PRINCETON SOUTH CORPORATE CTR STE 160
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City | EWING
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State | NJ
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Zip | 08628-3435
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Country | US
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Telephone | 877-742-2738
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Fax |
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Provider Business Mailing Address
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Address Line | 382 NE 191ST ST PMB 688082
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City | MIAMI
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State | FL
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Zip | 33179-3899
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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 | CEO
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Name | AVERY J KNAPP JR.
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Credential | M.D.
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Telephone | 415-903-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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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 | 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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