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NPI Code Detail

MEDICARE: LAKEWOOD RESOURCE AND REFERRAL CENTER INC

MEDICARE: LAKEWOOD RESOURCE AND REFERRAL CENTER INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QC1500XCommunity Health Clinic/Center24191NJ
2261QF0400XFederally Qualified Health Center (FQHC)24191NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083748297
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAKEWOOD RESOURCE AND REFERRAL CENTER INC
Provider Business Mailing Address
First Line : 1771 MADISON AVE
Second Line :
City : LAKEWOOD
State : NJ
Zip : 08701-1251
Country : US
Telephone Number : 732-364-2144
Fax Number : 732-364-3559
Provider Business Practice Location Address
First Line : 1771 MADISON AVE
Second Line :
City : LAKEWOOD
State : NJ
Zip : 08701-1251
Country : US
Telephone Number : 732-364-2144
Fax Number : 732-364-3559
Authorized Official
Title or Position : C.E.O.
Name : MR. DAVID FRIEDMAN
Credential :
Telephone Number : 732-364-2144
Provider Enumeration Date : 03/16/2007
Last Update Date : 04/25/2022

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Practice Location Address:
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1538267968 — SHIRA SPEISER LCSW
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1548338486 — DR. GLENN TONER DDS
Practice Location Address:
1771 MADISON AVE
LAKEWOOD, NJ
08701-1251
Practice Phone: 732-364-2144
Practice Fax:
1457410888 — DR. JEAN BERGHAUS M.D.
Practice Location Address:
1771 MADISON AVE
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08701-1251
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Practice Fax: 732-364-3559
1841335262 — DR. HOWARD D. UDERMAN M.D.
Practice Location Address:
1771 MADISON AVE , CHEMED
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1255452132 — DR. LAWRENCE G SHONER M.D.
Practice Location Address:
1771 MADISON AVE
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08701-1251
Practice Phone: 732-364-2144
Practice Fax: 732-364-3559

Directions to “LAKEWOOD RESOURCE AND REFERRAL CENTER INC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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