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Organization

LL ADVANCED AESTHETICS

Active
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Organization

LL ADVANCED AESTHETICS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LARISSA LOBATO APN (MANAGING MEMBER)
(732) 687-9212
Entity
Organization

Contact information

Practice address
750 BROAD ST STE 104, SHREWSBURY, NJ 07702-4230
(732) 687-9212
(732) 201-5709
Mailing address
23 N DELSEA DR UNIT B, CLAYTON, NJ 08312-1637
(856) 423-7700
(856) 423-0823

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary

Other

Enumeration date
12/19/2024
Last updated
09/05/2025
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