Individual
MOISES KAWEBLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 LUCERNE DR, LAKEWOOD, NJ 08701-2135
(732) 722-7593
(732) 722-7593
Mailing address
1 LUCERNE DR, LAKEWOOD, NJ 08701-2135
(732) 722-7593
(888) 965-2286
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
25MA07181100
NJ
208100000X
Physical Medicine & Rehabilitation Physician
25MA07181100
NJ
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
25MA07181100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018742630003
—
PA
05
—
0283118
—
NJ
01
—
1324383
BLUE SHIELD
PA
01
—
68694 269H
GEISINGER
PA
01
—
814886
FIRST PRIORITY
PA
Enumeration date
07/29/2005
Last updated
12/20/2024
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