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Organization
LSA SURGERY & CONSULTATION PC
Active
Organization
LSA SURGERY & CONSULTATION PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NINO J. CARNEVALE M.D. (PRESIDENT)
(201) 444-4412
Entity
Organization
Contact information
Practice address
145 PROSPECT ST, RIDGEWOOD, NJ 07450-4493
(201) 444-4412
Mailing address
145 PROSPECT ST, RIDGEWOOD, NJ 07450-4493
(201) 444-4412
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
25MA02025300
NJ
Other
Enumeration date
11/26/2012
Last updated
11/26/2012
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