Individual
DR. LAWRENCE THOMAS DEMILIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1122 ROUTE 22 WEST, 2ND FLOOR, MOUNTAINSIDE, NJ 07092
(908) 654-7399
(908) 654-7422
Mailing address
118 WOODBINE CIRCLE, NEW PROVIDENCE, NJ 07974-1757
(717) 330-1810
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
MD036633E
PA
Other
Enumeration date
03/27/2007
Last updated
07/08/2007
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