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Kmc Eeg Department Group

Psychiatry & Neurology, Neurology in Lakewood, NJ. Organization (NPI-2).

NPI number1790735017
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1790735017
Entity type
Organization (NPI-2)
Legal business name
Kmc Eeg Department Group
Organization subpart
No
Enumeration date
May 10, 2006
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2084N0400X Psychiatry & Neurology, Neurology––Yes

Practice location

600 River Ave
Lakewood, NJ 08701-5237

Phone 732-886-4443 · Fax 732-886-4659

Mailing address

Po Box 6069
Bellmawr, NJ 08099-6069

Phone 732-557-7160 · Fax 732-557-7109

Authorized official

Anthony Esposito
Director
7325577160

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