Organization
LAKEHURST PROFESSIONAL MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VINOD SANCHETI MD (OWNER)
(732) 240-4000
Entity
Organization
Contact information
Practice address
25 MULE RD UNIT B8, TOMS RIVER, NJ 08755-5037
(732) 240-4000
(732) 240-1441
Mailing address
25 MULE RD UNIT B8, TOMS RIVER, NJ 08755-5037
(732) 240-4000
(732) 240-1441
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MA06779200
STATE LICENCE
NJ
Enumeration date
09/26/2018
Last updated
09/26/2018
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