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General NPI Number Information
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NPI Number | 1730300856
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Entity Type | Organization
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Legal Business Name | COASTAL FOOT & ANKLE, LLC
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 01/30/2008
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Provider Practice Location Address
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Address Line | 1100 ROUTE 72 W SUITE 307
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City | MANAHAWKIN
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State | NJ
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Zip | 08050-2468
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Country | US
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Telephone | 609-597-5515
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Fax | 609-597-6789
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Provider Business Mailing Address
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Address Line | 1100 ROUTE 72 WEST SUITE 307
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City | MANAHAWKIN
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State | NJ
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Zip | 08050
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Country | US
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Telephone | 609-597-5515
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Fax | 609-597-6789
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Authorized Official
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Title or Position | OWNER
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Name | DR. THOMAS LEMBO JR.
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Credential | DPM
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Telephone | 609-597-5515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 25MD00277600
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License Number State | NJ
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