Organization
KENDALL PARK MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAIME F LARA M.D. (PHYSICIAN)
(732) 940-0505
Entity
Organization
Contact information
Practice address
3 STANWORTH RD # A, KENDALL PARK, NJ 08824-1003
(732) 940-0505
(732) 940-1997
Mailing address
3 STANWORTH RD # A, KENDALL PARK, NJ 08824-1003
(732) 940-0505
(732) 940-1997
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA04235300
NJ
Other
Enumeration date
07/29/2009
Last updated
07/29/2009
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