Organization
LAKESIDE NEUROLOGY & RADIOLOGY OF NEW JERSEY PC
Active
Other names
Lakeside Neurology Of New Jersey
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TOM G WINGER (DIRECTOR)
(847) 510-0530
Entity
Organization
Contact information
Practice address
1 GATEWAY CTR, #2600, NEWARK, NJ 07102-5310
(847) 510-0530
(888) 317-4206
Mailing address
1 GATEWAY CTR, #2600, NEWARK, NJ 07102-5310
(847) 510-0530
(888) 317-4206
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MA07746800
NJ
Other
Enumeration date
09/19/2007
Last updated
11/12/2009
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