| Esnj - Lacey (s) | |
|
15 Manchester Aveenue; Unit 10 Oakfield Plaza Forked River NJ 08731 | |
| (609) 693-1398 | |
| (609) 693-5197 |
| Full Name | Esnj - Lacey (s) |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 15 Manchester Aveenue; Unit 10, Forked River, New Jersey |
| Authorized Official Name and Position | Brian J Fitzgerald (PRESIDENT) |
| Authorized Official Contact | 7322576662 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Esnj - Lacey (s) 25 Kennedy Blvd Suite 600 East Brunswick NJ 08816-1259 Ph: (732) 257-6662 | Esnj - Lacey (s) 15 Manchester Aveenue; Unit 10 Oakfield Plaza Forked River NJ 08731 Ph: (609) 693-1398 |
| NPI Number | 1306226063 |
|---|---|
| Provider Enumeration Date | 06/08/2015 |
| Last Update Date | 06/08/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306226063 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (NU) | Primary |
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