Organization
KENNETH J LICHTMAN MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINA ALLAIRE (SEC)
(732) 549-2220
Entity
Organization
Contact information
Practice address
1109 AMBOY AVE, EDISON, NJ 08837-2877
(732) 549-2220
Mailing address
1109 AMBOY AVE, EDISON, NJ 08837-2877
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
25MA03137800
NJ
Other
Enumeration date
09/26/2017
Last updated
09/26/2017
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