Individual
LONNY MATLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
307 STONE HARBOR BLVD, CAPE MAY COURT HOUSE, NJ 08210-2170
(609) 465-4667
(609) 465-9387
Mailing address
307 STONE HARBOR BLVD, CAPE MAY COURT HOUSE, NJ 08210-2170
(609) 465-4667
(609) 465-9387
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MB04094300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0090415000
AMERIHEALTH #
NJ
05
—
0373109
—
NJ
01
—
2397210
AETNA HMO
NJ
01
—
5826793
AETNA PPO
NJ
01
—
P381427
OXFORD #
NJ
Enumeration date
07/21/2005
Last updated
01/21/2009
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