Lakeside Neurology & Radiology of New Jersey PC
NPI #1356537708 in Newark, New Jersey
Provider Information
- NPI Number
- 1356537708
- Entity Type
- Organization
- Organization Name
- Lakeside Neurology & Radiology of New Jersey PC
- Primary Specialty
- Specialist
- Enumeration Date
- Sep 19, 2007
- Last Updated
- Nov 12, 2009
Practice Location
- Address
- 1 GATEWAY CTR
- Address 2
- #2600
- City
- Newark
- State
- New Jersey
- ZIP Code
- 07102-5310
- Phone
- (847) 510-0530
Authorized Official
- Name
- MR. TOM G WINGER
- Title
- DIRECTOR
- Phone
- (847) 510-0530
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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