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General NPI Number Information
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NPI Number | 1962655472
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Entity Type | Organization
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Legal Business Name | NORMAN INDICH MD, LLC
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Dates
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Enumeration Date | 10/28/2008
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 603 W COUNTY LINE RD
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City | LAKEWOOD
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State | NJ
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Zip | 08701-1216
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Country | US
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Telephone | 732-730-9111
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Fax |
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Provider Business Mailing Address
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Address Line | 603 W COUNTY LINE RD
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City | LAKEWOOD
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State | NJ
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Zip | 08701-1216
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Country | US
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Telephone | 732-730-9111
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. NORMAN INDICH
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Credential |
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Telephone | 732-730-9111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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