Organization
SOUTHSHORE MEDICAL ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LIN XU M.D. (MANEGER)
(732) 888-1203
Entity
Organization
Contact information
Practice address
1 BETHANY RD, SUITE 35, HAZLET, NJ 07730-1663
(732) 888-1203
(732) 888-1204
Mailing address
1 BETHANY RD, SUITE 35, HAZLET, NJ 07730-1663
(732) 888-1203
(732) 888-1204
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
309505
AETNA HMO
NJ
Enumeration date
05/23/2007
Last updated
06/28/2010
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