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General NPI Number Information
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NPI Number | 1891964953
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Entity Type | Individual
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Provider Name | LAWRENCE R LODICO III CWS, ATS
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Gender | Male
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Dates
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Enumeration Date | 02/22/2008
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Last Update Date | 02/08/2018
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Provider Practice Location Address
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Address Line | 1601 TILTON RD STE 3
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City | NORTHFIELD
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State | NJ
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Zip | 08225-1858
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Country | US
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Telephone | 609-748-2434
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Fax | 609-748-3015
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Provider Business Mailing Address
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Address Line | 1601 TILTON RD STE 3
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City | NORTHFIELD
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State | NJ
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Zip | 08225-1858
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Country | US
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Telephone | 609-748-2434
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Fax | 609-748-3015
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 233010478
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License Number State | NJ
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