# EASTERN THORACIC SURGICAL ASSOCIATES LLC

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

## Provider details

- **NPI number:** 1881868263
- **Authorized official:** LOURENS J WILLEKES II M.D. (PHYSICIAN)
- **Authorized official phone:** (732) 741-9980

## Contact information

- **Practice address:** 65 MECHANIC ST, SUITE 102, RED BANK, NJ 07701-1869
- **Practice address phone:** (732) 741-9980
- **Practice address fax:** (732) 741-9982
- **Mailing address:** 65 MECHANIC ST, SUITE 102, RED BANK, NJ 07701-1869
- **Mailing address phone:** (732) 741-9980
- **Mailing address fax:** (732) 741-9982

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | NULL | Yes |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/17/2008
- **Last updated:** 07/24/2009