Individual
LAWRENCE GERALD BASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
67 CEDARBROOK AVE, BRIDGETON, NJ 08302-1611
(856) 519-8116
Mailing address
67 CEDARBROOK AVE, BRIDGETON, NJ 08302-1611
(856) 519-8116
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
07/09/2019
Last updated
07/09/2019
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