Lakewood Children's Clinic LLC
NPI #1952175614 in Manchester, New Jersey
Provider Information
- NPI Number
- 1952175614
- Entity Type
- Organization
- Organization Name
- Lakewood Children's Clinic LLC
- Primary Specialty
- Clinic/Center
- Enumeration Date
- Nov 13, 2023
- Last Updated
- Nov 13, 2023
Practice Location
- Address
- 8 LAKETREE CT
- City
- Manchester
- State
- New Jersey
- ZIP Code
- 08759-5679
- Phone
- (917) 957-2273
Authorized Official
- Name
- MICHAEL TYBERG, MD
- Title
- OWNER
- Phone
- (917) 957-2273
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center |
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