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General NPI Number Information
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NPI Number | 1982001434
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Entity Type | Organization
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Legal Business Name | LAKEWOOD OBSTETRICS & GYNECOLOGY PA
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Dates
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Enumeration Date | 11/28/2014
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Last Update Date | 08/24/2018
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Provider Practice Location Address
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Address Line | 1382 LANES MILL RD STE 201
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City | LAKEWOOD
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State | NJ
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Zip | 08701
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Country | US
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Telephone | 732-994-4242
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Fax | 732-363-5164
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Provider Business Mailing Address
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Address Line | 1382 LANES MILL RD STE 201
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City | LAKEWOOD
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State | NJ
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Zip | 08701-3833
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Country | US
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Telephone | 732-994-4242
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Fax | 732-363-5164
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Authorized Official
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Title or Position | OWNER
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Name | DR. CLARA SUROWITZ
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Credential | MD
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Telephone | 248-914-1139
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 25MA08638800
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License Number State | NJ
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