Individual
LAURENCE WYNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, MPH.
Contact information
Practice address
35 HACKENSACK AVE, KEARNY, NJ 07032-4635
(973) 491-5525
Mailing address
82 WEDGEWOOD DR, MONTVILLE, NJ 07045-9044
(973) 263-5336
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
25MA04463500
NJ
208D00000X
General Practice Physician
25MA04463500
NJ
Other
Enumeration date
05/01/2007
Last updated
09/11/2025
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