MEDICARE: DR. JOEL M MUSICANT M.D.

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
1	174400000X	Specialist	25MA06084300	NJ
2	207RG0100X	Gastroenterology Physician	25MA06084300	NJ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110057519	OTHER	NJ	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1174576052
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOEL M MUSICANT M.D.

Provider Business Mailing Address
First Line	:	475 ROUTE 70
Second Line	:	SUITE 103
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-5897
Country	:	US
Telephone Number	:	732-886-1007
Fax Number	:	732-886-0807

Provider Business Practice Location Address
First Line	:	475 ROUTE 70
Second Line	:	SUITE 103
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-5897
Country	:	US
Telephone Number	:	732-886-1007
Fax Number	:	732-886-0807

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	11/13/2025

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