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General NPI Number Information
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NPI Number | 1912238668
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Entity Type | Organization
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Legal Business Name | LINCOLN MEDICAL AND MENTAL HEALTH CENTER
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Dates
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Enumeration Date | 01/20/2010
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Last Update Date | 01/20/2010
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Provider Practice Location Address
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Address Line | 174 BRITTANY CT
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City | CLIFTON
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State | NJ
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Zip | 07013-2673
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Country | US
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Telephone | 973-928-1625
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Fax |
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Provider Business Mailing Address
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Address Line | 174 BRITTANY CT
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City | CLIFTON
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State | NJ
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Zip | 07013-2673
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Country | US
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Telephone | 973-928-1625
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Fax |
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | VIHREN DIMITROV
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Credential | M.D
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Telephone | 718-579-5000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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