| Lakewood Medical Associates, Llc | |
|
2290 W County Line Rd Jackson NJ 08527-2267 | |
| (732) 645-9988 | |
| Not Available |
| Full Name | Lakewood Medical Associates, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2290 W County Line Rd, Jackson, New Jersey |
| Authorized Official Name and Position | Lawrence Shoner (OWNER) |
| Authorized Official Contact | 7323207597 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakewood Medical Associates, Llc 2290 W County Line Rd Jackson NJ 08527-2267 Ph: (732) 645-9988 | Lakewood Medical Associates, Llc 2290 W County Line Rd Jackson NJ 08527-2267 Ph: (732) 645-9988 |
| NPI Number | 1851770606 |
|---|---|
| Provider Enumeration Date | 05/27/2015 |
| Last Update Date | 09/30/2015 |
| Medicare PECOS PAC ID | 4880903855 |
|---|---|
| Medicare Enrollment ID | O20151014002829 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851770606 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 25MA04600800 (New Jersey) | Primary |
| Provider Name | Lawrence G Shoner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255452132 PECOS PAC ID: 2062597461 Enrollment ID: I20080310000453 |
| Provider Name | Joseph D Sutton |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1295715571 PECOS PAC ID: 4880580265 Enrollment ID: I20191209000115 |
| Provider Name | Haya R Rubin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619058864 PECOS PAC ID: 3173524162 Enrollment ID: I20210525002467 |
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