| NPI | 1356537708 |
|---|---|
| Doing Business As | LAKESIDE NEUROLOGY OF NEW JERSEY |
| Entity Type | Organization |
| Authorized Contact | TOM G WINGER Director 847-510-0530 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NJ 25ma07746800) |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2009-11-12 |