Organization
PAI PARTICIPANT 25 PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN N LAIRD (AUTHORIZED OFFICIAL)
(410) 458-8713
Entity
Organization
Contact information
Practice address
290 RED SCHOOL LN, PHILLIPSBURG, NJ 08865-2276
(908) 859-2800
(908) 859-4532
Mailing address
PO BOX 639676, CINCINNATI, OH 45263-9676
(859) 291-4800
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
05/17/2019
Last updated
08/10/2020
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