# LAWRENCE GRILL MDPA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275561326
- **Authorized official:** MS. KELLY A DENNIS (OFFICE MANAGER)
- **Authorized official phone:** (732) 367-8272

## Contact information

- **Practice address:** 1166 RIVER AVE, LAKEWOOD, NJ 08701-5600
- **Practice address phone:** (732) 367-8272
- **Mailing address:** 1166 RIVER AVE, LAKEWOOD, NJ 08701-5600
- **Mailing address phone:** (732) 367-8272

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/29/2006
- **Last updated:** 06/12/2012