Individual
DR. MITCHEL A LAUTENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
601 ROUTE 37 WEST, TOMS RIVER, NJ 08755-8050
(732) 244-4400
(732) 505-2171
Mailing address
601 ROUTE 37 WEST, TOMS RIVER, NJ 08755-8050
(732) 244-4400
(732) 505-2171
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
25MAO6965100
NJ
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
25MA06965100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180039086
RAILROAD MEDICARE
NJ
05
—
8283508
—
NJ
Enumeration date
03/01/2006
Last updated
04/24/2017
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