Organization
LAKEWOOD SURGICAL GROUP PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. WANDA M PRETTO (OFFICE MANAGER)
(732) 341-0470
Entity
Organization
Contact information
Practice address
9 HOSPITAL DRIVE, SUITE C23, TOMS RIVER, NJ 08755-6425
(732) 341-0470
(732) 341-0473
Mailing address
9 HOSPITAL DRIVE, SUITE C23, TOMS RIVER, NJ 08755-6425
(732) 341-0470
(732) 341-0473
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0099331000
AMERIHEALTH
NJ
01
—
0112415
AETNA HMO
NJ
01
—
1018813
NEW JERSEY HEALTH
NJ
01
—
169045
UNITEDHEALTHCARE
NJ
01
—
CA6841
RR MEDICARE
NJ
Enumeration date
11/14/2006
Last updated
07/16/2010
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