MEDICARE: LWOODSKY CHARLES MD

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	207R00000X	Internal Medicine Physician	25MA12273600	NJ

General Provider Information

NPI Number	:	1225610405
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LWOODSKY CHARLES MD

Provider Business Mailing Address
First Line	:	331 NEWMAN SPRINGS RD STE 220
Second Line	:
City	:	RED BANK
State	:	NJ
Zip	:	07701-5792
Country	:	US
Telephone Number	:	732-807-0877
Fax Number	:	201-751-1680

Provider Business Practice Location Address
First Line	:	4 HUNTER ST
Second Line	:
City	:	LODI
State	:	NJ
Zip	:	07644-1608
Country	:	US
Telephone Number	:	201-650-1292
Fax Number	:

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

Provider Enumeration Date	:	04/26/2021
Last Update Date	:	07/10/2024

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Directions to “ LWOODSKY CHARLES MD” Practice Location

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