Organization
LAKEWOOD PEDIATRIC ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUMAN JAIN M.D. (PRESIDENT)
(732) 363-1424
Entity
Organization
Contact information
Practice address
101 PROSPECT ST, SUITE 112, LAKEWOOD, NJ 08701-5020
(732) 363-1424
(732) 370-0714
Mailing address
101 PROSPECT ST, SUITE 112, LAKEWOOD, NJ 08701-5020
(732) 363-1424
(732) 370-0714
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA02835000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1299301
—
NJ
Enumeration date
05/28/2006
Last updated
08/22/2020
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