Organization
LAKELAND CARDIOLOGY CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT M. WALL M.D. (PRESIDENT)
(973) 334-7700
Entity
Organization
Contact information
Practice address
415 BOULEVARD, MOUNTAIN LAKES, NJ 07046-1723
(973) 334-7700
(973) 263-5225
Mailing address
415 BOULEVARD, MOUNTAIN LAKES, NJ 07046-1723
(973) 334-7700
(973) 263-5225
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
207RC0000X
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6565506
—
NJ
Enumeration date
05/27/2006
Last updated
08/22/2020
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