Individual
DR. JEFFREY THOMAS LAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
703 MAIN ST, ST. JOSEPH'S REGIONAL MEDICAL CENTER, PATERSON, NJ 07503-2621
(973) 754-2323
(973) 977-9455
Mailing address
703 MAIN ST, ST. JOSEPH'S REGIONAL MEDICAL CENTER, PATERSON, NJ 07503-2621
(973) 754-2323
(973) 977-9455
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
25MB08901500
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/14/2008
Last updated
09/30/2013
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